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Janine is a 31 year old teacher who presents with a 6 month history of palpitations. She has recently joined the gym and noticed that when running on the treadmill she gets palpitations. These continue for around 5 minutes after stopping exercise. She denies any chest pain or shortness of breath. Sometimes she feels like she is about to faint but has never collapsed. She is a smoker and drinks 12 units of alcohol on average a week. Her BMI is 30. She is on Desogestrel for contraception and has no previous medical problems.

Which features in her history would prompt you to refer her to cardiology? Please select one or more answers.

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