Coronary subclavian steal syndrome in the emergency department - A case report.
Emma Shu Min Chow, Yang Zhao, Mervin Ye Qing Tan et al.
✦ AI-curated · Sources linked
Case in brief
A 77-year-old female with a history of CABG presented to the emergency department with chest pain. Her ECG indicated ST elevations in aVR and widespread ST depressions, alongside elevated high sensitivity Troponin levels, leading to a diagnosis of NSTEMI. Coronary angiography showed patent grafts, prompting further investigation that revealed left subclavian artery stenosis. Successful angioplasty of the stenosed artery resolved her symptoms.
What made this case unusual
The case highlights the occurrence of Coronary Subclavian Steal Syndrome in a patient with a history of CABG, which is a rare condition that can lead to cardiac ischemia due to retrograde blood flow.
Diagnostic / clinical pearl
Emergency physicians should consider Coronary Subclavian Steal Syndrome in patients with CABG presenting with chest pain and suggestive ECG changes.
Why it matters
Recognizing this syndrome can lead to timely intervention, potentially preventing further cardiac complications in patients with subclavian artery stenosis.