Factitious disorder presenting with acute cardiovascular symptoms

Area of Science:

• Psychiatry
• Cardiology
• Neurology

Background:

• Factitious disorder, previously known as Munchausen's syndrome, involves the intentional simulation of medical or psychological signs and symptoms.
• Chronic factitious disorder with physical symptoms presents a diagnostic challenge due to elaborate deception and extensive medical histories.

Observation:

• A 23-year-old female student presented with simulated cardiovascular and neurological conditions, including hypertension, arrhythmias, seizures, and unconsciousness.
• The patient employed techniques like the Valsalva maneuver to induce physiological changes, mimicking serious medical events.
• She had sought extensive medical evaluations and treatments across multiple countries, demonstrating a pattern of medical peregrination.

Findings:

• The patient exhibited classic features of chronic factitious disorder, including deliberate illness simulation, pseudologia fantastica, and dramatic presentations.
• Comprehensive cardiological, neurological, and endocrinological assessments were performed, revealing no underlying organic pathology.
• A literature review indicated a rising trend in factitious cardiovascular symptoms over recent decades.

Implications:

• This case underscores the importance of considering factitious disorder in patients with recurrent, unexplained, and complex multi-systemic symptoms.
• Healthcare providers must be vigilant in recognizing the patterns of deception and medical peregrination associated with Munchausen's syndrome.
• Increased awareness and diagnostic acumen are crucial for appropriate management and to prevent unnecessary medical interventions.