<s>[INST] I am 47 years old with a history of panic attacks and anxiety. This past week I have been experiencing a strange thump periodically (every hour or so) in my chest. It is painless and I have no other symptoms. Today I went to work out at the gym and while on the treadmill it became more apparent and I had to stop. Any thoughts? [/INST] What you have is palpitations. And that is part of your anxiety disease. You can start tablet alprazolam 0.25 mg daily twice and you would be fine. </s>