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.