Case presentation
A 20-year-old woman was being investigated privately for syncope in May 2017. Tilt-test showed that on standing, her heart rate increased by 30 beats/minute from baseline. She was referred to the cardiology team. Her body mass index (BMI) was 23 kg/m2 and average 24-hour ambulatory blood pressure was 141/79 mmHg. She had a normal echocardiogram and 24-hour urinary catecholamines. The patient completed the standard treadmill test. Because of hypertension detected in this patient, aldosterone/renin ratio (ARR) was performed to screen for primary hyperaldosteronism (Conn’s disease). ARR was found to be raised at 156 (referen
