Your patient is a 29-year old male who presents to the medical clinic stating that he has been having a feeling of a racing heart off-and-on for the last couple of months.  It comes and goes, maybe two or three episodes a week.  They only last a few minutes.  He feels odd when this happens but he does not have to stop his activities.  He has noticed no pattern to these; they have happened at work (he is an inmate worker), in the middle of the night and every time in between.

His physical exam is normal including blood pressure of 124/78, regular heart rate of 68 and normal heart sounds.

What do you think is going on?  Would you order any tests? Continue reading →