FACTITIOUS DISORDER PRESENTING WITH ACUTE CARDIOVASCULAR SYMPTOMS

A 23-year-old female student exhibited all the characteristics of chro nic factitious disorder with physical symptoms (Munchhausen's syndrome ): deliberate simulation of illness, peregrination, fantastic pseudolo gy and dramatic circumstances on admittance. The patient induced impre ssive blood pressure peaks by the Valsalva manoeuvre. She also simulat ed arrhythmias, seizures and unconsciousness. Her symptoms had previou sly led to comprehensive cardiological, neurological and endocrinologi cal evaluations and treatment in at least three different countries in two continents. A literature survey suggests that factitious cardiova scular symptoms have become more frequent during recent decades.