Let's play doctor

I know: the course is over, the exam has been taken (and the results are not bad at all!) - but the following story is of some interest in your class, and i would expect at least one idea of what could have caused the symptoms in the lady...:
Yesterday I got an email from a lady from Brooklyn. She is about 30-35 years old, has an 11 yo son, works, seems to lead a healthy lifestyle...had no significant illnesses.
Here is what she wrote:
" ...I had some twitching on my tongue and neck accompanied with shortness of breath.  They did an EKG and my primary care physcian has referred me to see a cardiologist because "there is an abnormality in my EKG..."
She is very worried and scared.
So, what do you think? What would you do with this patient? What would you ask her, what are these symptoms about, what could her condition be...?
Send me your comment....
Meanwhile I will ask around, and I suppose I will also hear from her and see what came out of her referrals and maybe get a meaningful answer. I don't have her EKG and do not know what the "abnormality" was. What abnormality would you expect, in line with the above symptoms??

Propranolol and surgery performance

James Parker did some research and found us a neat reference for a study where they tested the hypothesis that use of propranolol (40 mg) would improve the performance of a resident surgeon. You may recall that this question was brougth up in class. Indeed, there was less nervous tremor and anxiety (note that this is the probably the cardiac rate consequence of anxiety, not the anxiety sense itself) after taking propranolol. Also note that the summary conclusions  carefully state that the ultimate outcome, namely improved surgery, was not tested in this study! I would add also that these were residents that were tested - seasoned surgeons probably would not show any more tremor or anxiety - I hope!


Thanks James, great job!