A 47-year-old woman telephones your surgery and says, “I can hear my boyfriend's heartbeat—from three feet away!” Do you:

1. arrange an urgent psychiatric review for this obviously delusional woman?

2. arrange an urgent psychiatric review for the Editors of Thorax for publishing a cardiology case report?

3. or do something else?

On urgent review after the phone call, you can hear what sounds like his amplified heart sounds from over a metre away, especially if he leans backwards.

This …