I have been having more 'episodes' since low carbing and especially after a higher fat meal or snack. My arm starts throbbing with severe pain and my chest feels like it's being crushed. I went to the dr. during one episode and the ekg was ok but the ultrasound test (can't think of the name) showed a lot of abnormal activity with the valve. I was told to eat really low fat and exercise at least 30 minutes a day, but to stop immediately if I felt pain or discomfort.