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Subclavian stenosis presenting as progressive exertional angina pectoris
D M Slutzker1, M A Capeless, K A Brown
1Department of Medicine, University of Vermont, College of Medicine, Burlington.
Clinical Cardiology
|March 1, 1990
Summary
Left subclavian stenosis can cause exertional arm pain mimicking angina. Prompt diagnosis and angioplasty resolved symptoms, emphasizing blood pressure checks in patients with atherosclerosis risk factors.
Area of Science:
- Cardiovascular Medicine
- Vascular Surgery
Background:
- Exertional left arm pain is often attributed to cardiac ischemia.
- Left subclavian stenosis is an infrequent cause of such symptoms.
Observation:
- A patient presented with worsening exertional chest and left arm pain.
- A significant blood pressure difference was noted between the arms.
- Exercise stress testing showed normal heart perfusion.
Findings:
- Angiography revealed high-grade stenosis in the proximal left subclavian artery.
- Successful angioplasty treatment led to complete symptom resolution.
Implications:
- Left subclavian stenosis can manifest as accelerated angina.
- Routine bilateral arm blood pressure measurement is crucial for atherosclerosis risk assessment.