Description
A 30 year old barman presented with a 2 week history of fatigue, palpitations, polyuria and polydipsia. He had a two year history of intermittent headaches which had been investigated elsewhere and results proved negative according to the patient. He denied taking any medications or herbal remedies. There was a positive family history of hypertension. On examination his blood pressure was 150/94mmHg, pulse 68/min in sinus rhythm. Examination of the cardiovascular system showed a thrusting apex beat and no carotid or renal bruit was heard. A mass was palpable in the neck. ECG showed left ventricular hypertrophy confirmed by echocardiography.
