Patient’s Story 

You are Emily, a 15-year-old secondary school student. You have booked this telephone consultation to talk about episodes of dizziness, fainting, and a fast heartbeat that have been occurring over the past six months.

Opening statement: Hello doctor, I’ve been feeling really dizzy lately, and sometimes I even faint. It’s been happening for a few months now, and I’ve noticed my heart races when I stand up. I’m a bit worried about this now. 

If asked why you are worried, reply: I am worried because my GCSEs are coming up, and I don’t want this to get in the way.

(Only disclose the following details if specifically asked to explain further):
The dizziness tends to happen after standing up from sitting for a long time or when standing still for long periods, such as during school assemblies.
When you stand up, your heart starts to race, and you feel light-headed. This usually settles when you sit down again.
You have fainted on six occasions. Each time, the episode lasted only a few seconds, and you recovered quickly without confusion.
Your mother recently bought you a smartwatch, and you’ve noticed your heart rate sometimes goes up to 125 beats per minute.

You do not experience chest pain or shortness of breath. The palpitations (heart racing) only occur when standing up suddenly.
You have not identified any other clear triggers, but the symptoms do seem worse when you’re stressed, particularly now, as you’re preparing for your GCSE exams.