Rapid heartbeat with malaise may be caused by physiological reasons such as overwork and pathological reasons such as anemia. 1. Physiological causes: Normal people often experience rapid heartbeat and fatigue after overworking or staying up late. 2. Pathological causes: some systemic diseases such as anemia and hypothyroidism can cause general weakness and rapid heartbeat; cardiovascular and cerebrovascular diseases such as hypertension, angina pectoris and cerebral infarction can also cause the above symptoms; in addition, middle-aged women combined with menopausal syndromes may also have such a manifestation. When the symptoms of rapid heartbeat accompanied by fatigue occur repeatedly, the patient should pay attention to rest and go to the hospital in time, and the doctor will prescribe relevant tests such as blood routine, thyroid function, biochemistry, electrocardiogram and so on according to the patient’s condition to clarify the cause of the disease, so as to provide timely treatment.