Hello and thank you for using HCM.I carefully read your question and I understand your concern. You should not worry. I ll try to explain you something and give you my opinion. You should know that this palpitation has to do with a rhythm issue. There are some electrical impulses that generates in parts of the heart different from normal sinus rhythm.They cause a premature heart contaction that its not a normal one. You feel like a skipped beat, palpitations, difficulty in breathing deeply, anxiety and this symtoms might disappear when you caught becoise of changes in inta-thorachal pressure. This extra beats are sporadic and it might be difficult to catch them whith a simple ecg. The reasons of thisrhythm issue might be different to simple emotional stress ,coffee or energy drink consumption, patologyes like anemia , hyperthyroidism , electrolyte imbalances or cardiac diseases. So,if this happens once a while you should not worry, its normal.If these bother you and start to interfere in your daily life than if I was your treating doctor I would recommend some examination like a cardiac echo to evaluate heart function and valves for your murmurs, a full blood analyze,your thyroid hormones and a holter rhythm monitoring to see your rhythm tendency. Only after this we can better understand if it is necesary to treat this rhythm issues. Hope I was helpfull. Best regards, Dr.Ervina.