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.