Clinical examination revealed a healthy young man with no signs of
thyroid dysfunction, goitre or orbitopathy. His pulse rate was 60/min
and with dropped beats. His systems examination was normal. ECGs showed
isolated ventricular ectopics with broad complexes. His echocardiogram
was normal. He was reviewed in the cardiology clinic and was later
discharged.
Possible differentials at this point included assay interference,
thyroid hormone resistance and a TSH secreting pituitary adenoma.