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Münchhausen Syndrome simulating acute aortic dissection
Richard A Hopkins1, Colin J Harrington, Athena Poppas
1Department of Cardiothoracic Surgery, Brown University, Rhode Island Hospital, Providence, Rhode Island 02905, USA. rahopkins@lifespan.org
The Annals of Thoracic Surgery
|March 28, 2006
Summary
This case study highlights a young adult male with Münchhausen Syndrome who feigned acute aortic dissection. His deception led to unnecessary invasive procedures, including a median sternotomy.
Area of Science:
- Medical Case Study
- Psychiatry
- Cardiology
Background:
- Acute aortic dissection requires urgent diagnosis and parallel pharmacologic management.
- Münchhausen Syndrome is a factitious disorder characterized by intentional falsification of symptoms or induction of injury.
Observation:
- A young adult male presented with symptoms suggestive of acute aortic dissection.
- Extensive travel and history of misrepresenting diagnoses across facilities were noted.
- Transesophageal echocardiography revealed normal cardiac and aortic structures.
Findings:
- The patient intentionally misrepresented his condition to deceive clinicians.
- He underwent unnecessary invasive procedures, including a median sternotomy.
- The presentation was consistent with Münchhausen Syndrome.
Implications:
- This case underscores the challenges in diagnosing factitious disorders, especially when mimicking life-threatening conditions.
- It highlights the importance of thorough patient history and critical evaluation to prevent iatrogenic harm.
- Awareness of Münchhausen Syndrome is crucial for clinicians managing complex or unusual presentations.