title: Case report: stimulation of severe hypertension as a means of malingering.
abstract: Severe hypertension frequently requires hospitalization. Although hospital admission is undesirable for most patients, others are motivated to achieve hospitalization status for secondary gain. The authors present a case of a prison inmate who simulated severe hypertension with a combination of Valsalva's maneuver and arm flexion, on the background of preexisting essential hypertension and mitral valve prolapse. His secondary intent--to avoid his prison duties--classifies him as a malingerer. The differences between this malingering and the psychiatric diagnosis of Munchausen syndrome are discussed. The contributions of essential hypertension and mitral valve prolapse to the self-induced blood pressure elevations also are considered.
authors.affiliation: Department of Medicine, University of Texas Medical Branch, Galveston.
authors.forename: B L
authors.initials: BL
authors.lastname: Rude
authors.forename: R R
authors.initials: RR
authors.lastname: Townsend
authors.forename: D J
authors.initials: DJ
authors.lastname: DiPette
mesh_terms: D000328:Adult; D001794:Blood Pressure; D003937:Diagnosis, Differential; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008306:Malingering / Q000175:diagnosis* / Q000503:physiopathology; D009110:Munchausen Syndrome / Q000175:diagnosis; D011329:Prisoners