Factitious aortic dissection leading to thoracotomy in a 20-year-old man

Psychosomatics. Jul-Aug 2007;48(4):355-8. doi: 10.1176/appi.psy.48.4.355.

Abstract

A 20-year-old man presented to an emergency department with dramatic, sudden-onset, tearing chest pain. He also claimed to have been previously diagnosed with Ehler-Danlos syndrome and a previous Type I aortic dissection (intimal tear of ascending aorta), rapidly increasing his treating physician's suspicion of an emergent aortic dissection. The patient was quickly transferred to a large university hospital, where he underwent a median sternotomy and thoracotomy, with no aortic pathology found on operation and biopsy. After the patient's postoperative recovery, he was treated at a mental health facility, where he remained ambivalent about his psychiatric condition and did not respond well to treatment. This case report describes a unique case of factitious disorder that led to a serious operative intervention and subsequent psychiatric care and assesses factors that might have contributed to his hospital course.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aortic Rupture / diagnosis*
  • Aortic Rupture / surgery*
  • Diagnosis, Differential
  • Factitious Disorders / psychology*
  • Humans
  • Male
  • Psychomotor Agitation / psychology
  • Thoracotomy