Coronary subclavian steal syndrome in a patient with Behçet's disease

Area of Science:

• Cardiovascular Medicine
• Rheumatology
• Vascular Surgery

Background:

• Behçet's disease is a rare multisystemic inflammatory disorder.
• Vascular complications, including arterial occlusive disease, are known manifestations of Behçet's disease.
• Coronary artery bypass surgery is a treatment for severe coronary artery disease.

Observation:

• A 44-year-old woman with a history of Behçet's disease presented with recurrent dizziness and angina pectoris.
• Symptoms were exacerbated by left arm movement, suggesting a potential vascular steal phenomenon.
• Previous coronary artery bypass surgery had been performed.

Findings:

• Coronary angiography identified a critical stenosis in the left subclavian artery.
• This stenosis was diagnosed as coronary subclavian steal syndrome.
• The subclavian artery stenosis was attributed to the underlying vasculopathy of Behçet's disease.

Implications:

• This case highlights the potential for Behçet's disease to cause significant vascular occlusive changes, even in the subclavian artery.
• Coronary subclavian steal syndrome should be considered in patients with Behçet's disease experiencing relevant symptoms post-revascularization.
• Early recognition and management of vascular complications are crucial in patients with Behçet's disease.