How can you tell if the heart palpitations are from a anxiety attack or something different. had this yesterday with shaking, ?

Medical tip: Here's a tip.... when you feel palpitations EXERCISE (EG: Run in place) Palpitations will cease after your heart rate returns to normal. In other words REGULAR EXERCISE will help anxiety related "palps".. Hope this helps Dr Z

Need an eval: Unfortunately, the only way to distinguish between these possibilities is to be evaluated in person. Sometimes even when seen in person, if you aren't having the symptoms right then, it still can be difficult.