Münchhausen Syndrome Simulating Acute Aortic Dissection

A young adult man presented to the emergency department reporting a convincing story for acute aortic dissection, a disorder in which diagnostic evaluations should occur in parallel with pharmacologic management. Transesophageal echocardiography demonstrated normal cardiac and aortic structures. Additional history was notable for extensive travel across numerous medical facilities with associated misrepresentation of his diagnosis and treatment. The patient was willing to undergo unpleasant and invasive procedures and succeeded at least once in the past to deceive clinicians to the point of performing a median sternotomy. The intentional presentation of false information leading to unnecessary treatments is consistent with Münchhausen Syndrome.