Young woman's "hysteria" turns out to be aortic dissection

  1. A 29-year-old German woman went to the ER thinking she was having a breakdown. She was very anxious, and reported a serious fight with her boyfriend earlier that day. Her hysteria turned out to be an aortic dissection. Fortunately she survived after emergency surgery.

    A woman in Germany who went to the emergency room because she felt "hysterical" ended up not having a psychiatric disorder as doctors originally suspected. Instead, she had a serious heart condition that could have killed her, according to a new report of her case.

    Although the woman's symptoms seemed to be mainly psychological in nature and she was not in any pain, her doctors noticed some key physical clues that led them to the correct diagnosis, and likely saved her life. The case shows that people who have physical illnesses may have no physical pain but instead have psychiatric symptoms, the doctors who treated her wrote in their report.
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  2. 5 Comments

  3. by   imintrouble
    I'm a pretty good nurse, but the above illustrates perfectly where I'm lacking. I know I would have dismissed that woman as psych.
    I work on it and work on it, and I vow I'll do better, but I don't.
    It's not a part of me I like.
  4. by   OCNRN63
    My first job was in psych. One day we had a young Hispanic woman who was admitted for panic attacks. She poke very little English, so since I speak Spanish, I talked to her. She described an odd feeling in her chest, so I got my stethoscope and listened to her chest.

    Whoopsie! Pt. had MVP, not a psych diagnosis. She was discharged with an Rx for a beta blocker and a follow up appointment with Cardiology.
  5. by   AJJKRN
    It just goes to show that that horrible feeling of "impending doom" can be expressed in a more unconventional way.
  6. by   dream'n
    I have seen a patient with bilateral, multiple PE's present and state "I'm having anxiety attacks, I get nervous and short of breath. It comes and goes for the last few days." Patient was convinced it was anxiety.
  7. by   Altra
    The article states she presented with pallor, mottling, and cyanosis. I don't think astute clinicians would dismiss these signs without investigation. But the headline focus on her anxiety makes a great human interest story, no?

    Denial is present in many potentially critical situations. On a number of occasions I have spent an anxious elevator ride to the cath lab with a patient who was fuming that "you're all overreacting" while I constantly watched the monitor.

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