Common causes of palpitation include a. strong emotional responses such as fear b. stress or anxiety c. strenuous exercise d. caffeine/nicotine e. medicines such as pseudoephedrine, propanolol, atenolol etc Occasionally heart palpitations can be a sign of a serious health problem, such as c. overactive thyroid gland - hyperthyroidism d. abnormal heart rhythm - cardiac arrhythmia Arrhythmias may include very fast heart rates (tachycardia), unusually slow heart rates (bradycardia) or an irregular heart rhythm. Your resting heart rate has always been 55 – 66 per minute. This is low heart rate. Are taking any beta blocker such as propanolol,bisoprolol, atenolol or meteprolol. Beta blockers are used for the treatment of high blood pressure. Beta blockers cause low resting heart rate. Advice 1. Take rest and avoid all sorts of strenuous activity 2. Alprazolam 0.25 mg at bed time per oral for 1 month 3. Take other medicines regularly 4. Avoid tea, coffee, alcohol and smoking 5. Lose weight if you are overweight 6. Regularly check your blood pressure 7. Investigation a. ECG at the time of heart palpitation b. Holter monitoring c. Lipid profile d. Serum creatinine Consult a cardiologist with report. Thanks