Hello. Thank you for your question and welcome to HCM. I understand your concern.
Well, if this hard heart beat is also associated sometimes with a
shortness of breath, combining with the lack of sleep and/or with the usage of energetic drinks or other caffeine-containing beverages, it most probably is an extrasystole (''skıpped'' heart beat). In young ages and when they are not usual phenomenons within a day, there is nothing to worry about. Stressful moments in life, physical or psychological, can be associated with
extrasystoles. If this is a worrisome event to her and to you, I recommend her to be put on a 24-hour Holter rhythm monitor, to determine exactly what are these phenomenons, and if they are present, are there enough episodes a day to warrant treatment (because there is a cut-off line in the number of extrasystoles that can be tolerated). Instead, there is the option of the episode rhythm monitor - a machine who can be turned on and off by user, when he/she experiences the symptom. When the readings are ready, I suggest you to
consult a cardiologist or feel free to ask me again.
I hope I was helpful. Take care.
Best regards,
Dr. Meriton