Factitious disorder presenting with acute cardiovascular symptoms

. A 23-year-old female student exhibited all the characteristics of chronic factitious disorder with physical symptoms (Munchhausen's syndrome): deliberate simulation of illness, peregrination, fantastic pseudology and dramatic circumstances on admittance. The patient induced impressive blood pressure peaks by the Valsalva manoeuvre. She also simulated arrhythmias, seizures and unconsciousness. Her symptoms had previously led to comprehensive cardiological, neurological and endocrinological evaluations and treatment in at least three different countries in two continents. A literature survey suggests that factitious cardiovascular symptoms have become more frequent during recent decades.