ABSTRACT
A 19-year-old man presented to the emergency department complaining of palpitations, which had come on 40 minutes earlier. He denied any associated symptoms of chest pain or shortness of breath. He had been experiencing palpitations two to three times per week over the past year, but they had all self-resolved within 5 minutes. He reported seeing a doctor a few months earlier to discuss symptoms of anxiety and panic attacks that he had associated with commencing a university course. He complained of unintentional weight loss and nausea over recent months, which he also felt was due to stress at university. He had no significant past medical history and took no regular medications, although he admitted to occasionally taking an unspecified dose of diazepam, which he had obtained from a relative, when he felt anxious. He had a part-time job in the university bar and drank around 20 units of alcohol per week. He smoked cannabis three to four times per week in addition to around 10 cigarettes per day. He had several recent female sexual partners but reported always using barrier contraception.
