ABSTRACT
Thyrotoxicosis is a common cause of these symptoms, and in primary care is not always an easy diagnosis to make. It is much more common in women than in men. Hyperthyroidism has many clinical manifestations; however atrial fibrillation and anxiety are common. Medical and psychiatric conditions can either mimic or precipitate anxiety, and anxiety states are amongst the most common psychological conditions ofmodern times. Atrial fibrillation (AF) causes an irregularly irregular pulse that can be confirmed on clinical examination by demonstrating an apico-radial delay. AF becomes more common with increasing age, affecting 0.5% of people aged 40–50 years, and 9% of those aged 80–90 years. Definitive management should be instigated in secondary care. Stridor is a sign of extra-thoracic airway obstruction and is a medical emergency.
