Hi. Last night and again today, I ve noticed a large and noticeable pulsation in my neck in the area of the carotid artery. It s especially pronounced when I m supine. This afternoon, while at work, I noticed the pulsations in my neck and then, shortly after, realized my right hand was shaking and the arm felt weak. It subsided after a few minutes. When I returned home this evening, I noticed the beating in my neck and, using a video camera on my phone, confirmed the pulsations are visible and most visible when I m lying down or back on pillows. I feel okay otherwise, although my arm and shoulder again feel a little strange. (Although, truthfully, I m wondering if I m just reading into things a little bit.) I do have a history of heart issues: I had a patent foramen ovale closed in my heart in 2010 due to several years worth of strange symptoms (visual, pins & needles, etc.) that were likely ongoing and sporadic TIAs, according to my cardiologists. I have had no repeat episodes since the surgery, although have had a few cases of pericarditis since then. Otherwise, I am in excellent health/fitness. Weight ~130. Height ~5 6 . Physically active, no drug use, occasional social alcohol use. No family history of cardio disease. The question: should I be concerned about these symptoms and go to the ER, or is it normal? Or, somewhere in between those two extremes?