### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
i am 48 years of age and wake up at nights to loud heartbeats, sometimes fast......i visited my doctor who told me it might be depression and gave me alpraz.....he also gave me omiprezole for acid reflux but i get no ease......i exercise alot and try not to eat after 6pm. This has been happening about1 month now every night......

### output:

Hello and thank you for using Chat Doctor. I carefully read your question and I understand your concern. I will try to explain you something and give you my opinion. You should know that this loud, fast heart beats has to do with a rhythm issue. It might be just a sinus tachycardia meaning that your heart beats over 100 beats for minute, and you feel it like a strong and fast beat. Itmight be what we call extra systolic beats that are some electrical impulses that generates in parts of the heart different from normal sinus rhythm. They cause a premature heart contraction that it's not a normal one, and you feel a pause and then a palpitation or a strong beat. The causes of this rhythm issue might be different. Emotional stress is one of them. But there are other reasons like excessive coffee consumption or pathologies like anemia, hyperthyroidism or electrolyte imbalance, heart pathologies, gastric problem like reflux etc. So, if you have still the same symptoms after using an anxiety medication than it's time to do some examination. I would recommend an electrocardiogram, a cardiac echo, a full blood analyze to exclude previous problems and the most important one a holder rhythm monitoring to see your rhythm tendency. Only after this we can be sure what we are dealing with and how to treat it. Hope I was helpful. Best regards, Chat Doctor. 