CARDIOPATHIA FANTASTICA EXPOSED BY RAPID SEQUENTIAL SERUM CREATINE-KINASE ANALYSIS

Rapid, sequential serum creatine kinase measurements may be used to ex clude acute myocardial infarction in patients presenting with acute ch est pain. Two cases of cardiopathia fantastica (the cardiac variant of Munchausen's syndrome) are described. Both patients presented with sy mptoms of acute myocardial infarction and had electrocardiographic cha nges consistent with this diagnosis. Both patients also had a raised s erum creatine kinase level at the time of presentation but were unable to mimic the rise in serum creatine kinase associated with acute myoc ardial infarction, Munchausen's syndrome was suspected when both patie nts responded poorly to news that their enzyme results excluded acute myocardial infarction.