Coronary-Subclavian Steal: Case Series and Review of the literature

Abstract

Coronary subclavian steal syndrome (CSSS) is a relatively uncommon entity, and its clinical spectrum is characterized by stable exertional angina and rarely as acute coronary syndrome. The diagnosis can be established easily by angiography.We report a case series of three patients with CSSS and acute coronary syndrome and we review the literature in the attempt to understand the nature of symptomatology and the mechanisms of ischemia in this condition. Our study raised some questions about the correct definition of this entity, the pathophysiology of coronary steal and the mechanisms of ischemia, in the setting of unstable angina and acute myocardial infarction.

Successful treatment of total occluded innominate artery in a patient with subclavian steal syndrome

“…İnnominate artery occlusive disease is often associated with cerebrovascular symptoms such as subclavian steal syndrome, arm claudication, distal embolization, and stroke. In some patients, subclavian steal syndrome can present with symptoms of arterial insufficiency afflicting the brain, typically manifesting as transient brain ischemia (2). Percutaneous interventions have evolved as an effective and safe treatment modality for occlusive lesions of the subclavian and innominate arteries (3).…”

A Unique Case of STEMI STEALing the Flow

“…Both non–ST-segment and ST-segment elevation myocardial infarction have been described with CSSS, although the latter is much rarer ( 2 , 3 , 4 , 5 ). The initial diagnosis of CSSS is usually by noninvasive imaging with duplex ultrasound, CT angiography, or magnetic resonance angiography.…”

Unexpected Stealing From the Heart

“…This may reflect either type 1 or type 2 myocardial infarction (MI). Acute MI in the setting of CSSS is most likely due to type 2 MI, as per the recent MI classification, and not to an ulcerated or complicated atherosclerotic plaque [ 6 ]. For clarification, type 2 MI is secondary to relative ischemia from increased oxygen demand or decreased oxygen supply such as in the case of anemia, tachy-arrhythmia, coronary artery spasm, coronary embolism, hypertension, and/or hypotension [ 7 ].…”