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Coronary subclavian steal syndrome
C D Bicknell1, A Subramanian, J H N Wolfe
1Department of Vascular Surgery, St Mary's Hospital, London W2 1NY, UK.
Summary
Subclavian steal syndrome involves reversed blood flow in the vertebral artery due to subclavian artery stenosis, causing symptoms with arm movement. Coronary subclavian steal is a rare complication after coronary artery bypass grafting (CABG).
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Neurology
Background:
- Steal syndromes, characterized by abnormal blood flow, are recognized vascular phenomena.
- Subclavian steal syndrome involves proximal subclavian artery stenosis leading to vertebral artery flow reversal and vertebrobasilar ischemia symptoms during arm exertion.
Observation:
- Coronary subclavian steal can occur post-coronary artery bypass grafting (CABG).
- This occurs when retrograde flow from the myocardium through the internal mammary artery graft to the subclavian artery is caused by proximal subclavian stenosis.
Findings:
- Coronary subclavian steal is a rare but significant complication following CABG.
- It presents as a cause of recurrent chest pain in patients who have undergone coronary artery bypass surgery.
Implications:
- Awareness of coronary subclavian steal is crucial for diagnosing post-CABG chest pain.
- Early recognition and management can prevent recurrent symptoms and improve patient outcomes after coronary artery bypass surgery.