Factitious aortic dissection leading to thoracotomy in a 20-year-old man.
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.
Chambers
Elise
E
Department of Psychiatry/MSC09 5030, University of New Mexico School of Medicine, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA.
Yager
Joel
J
Apfeldorf
William
W
Camps-Romero
Eduardo
E
D000328:Adult; D001019:Aortic Rupture / Q000175:diagnosis* / Q000601:surgery*; D003937:Diagnosis, Differential; D005162:Factitious Disorders / Q000523:psychology*; D006801:Humans; D008297:Male; D011595:Psychomotor Agitation / Q000523:psychology; D013908:Thoracotomy