Hello, Anemia causes hypoxia (lack of oxygenation) due to decreased hemoglobin level. The clinical and hemodynamic changes due to acute, short-lasting anemia are reversible; but long-term (chronic) anemia will lead to progressive heart enlargement due to volume overload. Cardiovascular compensatory consequences of chronic anemia include tachycardia/fast heartbeats (like what you felt), increased cardiac output, and all hyper dynamic state can develop the risk of hypertension and cardiovascular disorder. Iron deficiency anemia is a comorbidity of chronic kidney disease (CKD). In people with CKD, anemia is an independent risk factor for the development of cardiovascular disease. Your symptom (fast heartbeats) is one sign of cardiovascular compensation. Various management therapeutic options for anemia in people with CKD include oral iron, IV iron injection, erythropoiesis-stimulating agent (ESA) and blood transfusion. You can contact your treating doctor to get best treatment for your health condition. Treating your anemia promptly positively can fix your heartbeats. It s good to know that your heart examination is normal but you should concern to do regular examination of laboratory (renal function test, complete blood count, etc.) and ECG or echocardiogram. If there s another sign of severe cardiovascular symptoms, please meet your treating doctor soon. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asti Yuliadha