Coronary-subclavian steal syndrome in a hemodialysis patient with ipsilateral subclavian artery occlusion and contralateral vertebral artery stenosis “Case Report”

Coronary‐subclavian steal syndrome causing myocardial infarction after arteriovenous fistula creation: a case report

“…8 A stress scintigraphy during a check-up enabled the diagnosis in one observation. 12 Symptoms appeared during haemodialysis sessions in three cases, 8,9,13 while they appeared after the AVF in four cases and were felt at rest or during exertion. 7,10,11,15 While in our report, DPs <60 mmHg and digital-brachial indexes (ratio of DPs to contralateral brachial SBP) <0.40 with compatible symptoms allowed the diagnosis of HAIDI 2 and supported the steal phenomenon theory, symptoms suggestive of HAIDI had previously been reported only once and resolved when LSA patency was restored, but no objective haemodynamic measurements were performed at that time.…”

“…5 Low LVEF was found to be related with the occurrence of adverse cardiac events in a retrospective study of 25 patients in whom three cases of myocardial infarction occurred following AVF homolateral to a CABG graft. 6 Among the few reported clinical observations of symptomatic CSSS caused by a left ITA graft, the recent creation of an AVF ipsilateral to the graft, and the presence of concomi- tant LSA stenosis, [7][8][9][10][11][12][13][14][15] the clinical presentation was NSTEMI in two cases, unstable angina in five cases, 7,[9][10][11]13 and pulmonary oedema in one case. 8 A stress scintigraphy during a check-up enabled the diagnosis in one observation.…”