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Coronary-Subclavian Steal: Case Series and Review of the Literature.

Marc M, Iancu A, Molnar A, Bindea D - Clujul Med (2015)

Bottom Line: 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.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.

View Article: PubMed Central - PubMed

Affiliation: "Niculae Stăncioiu" Heart Institute, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

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.

No MeSH data available.


Related in: MedlinePlus

Severe stenosis of left subclavian artery.
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f3A-cm8801p79: Severe stenosis of left subclavian artery.

Mentions: A 51 year-old man presented in 2001 with chest pain at rest and dyspnea. He had a history of prior inferior myocardial infarction (1996) and had CABG few months later (LIMA to LAD and SVG to the RCA). At presentation, the ECG revealed inferior wall ischemia as well as 2 mm transient ST segment elevation in V1–V4. The CK-MB (creatine kinase myocardial band fraction) was increased. Echocardiogram showed an EF (ejection fraction) of 45%. Coronary angiography, performed after 24 hours after admission, demonstrated patency of the two grafts, proximal high degree LAD stenosis and severe stenosis of the proximal left subclavian artery - which was considered the culprit lesion. This was stented using a Jostent 4–9 mm/28 mm (Jomed GmbH, Rangendingen, Germany), mounted on a 9×4 cm OPTA balloon angioplasty catheter (Cordis, Miami Lakes, FL). No residual stenosis was noted and the clinical status significantly improved (Fig. 3 A, B).


Coronary-Subclavian Steal: Case Series and Review of the Literature.

Marc M, Iancu A, Molnar A, Bindea D - Clujul Med (2015)

Severe stenosis of left subclavian artery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508614&req=5

f3A-cm8801p79: Severe stenosis of left subclavian artery.
Mentions: A 51 year-old man presented in 2001 with chest pain at rest and dyspnea. He had a history of prior inferior myocardial infarction (1996) and had CABG few months later (LIMA to LAD and SVG to the RCA). At presentation, the ECG revealed inferior wall ischemia as well as 2 mm transient ST segment elevation in V1–V4. The CK-MB (creatine kinase myocardial band fraction) was increased. Echocardiogram showed an EF (ejection fraction) of 45%. Coronary angiography, performed after 24 hours after admission, demonstrated patency of the two grafts, proximal high degree LAD stenosis and severe stenosis of the proximal left subclavian artery - which was considered the culprit lesion. This was stented using a Jostent 4–9 mm/28 mm (Jomed GmbH, Rangendingen, Germany), mounted on a 9×4 cm OPTA balloon angioplasty catheter (Cordis, Miami Lakes, FL). No residual stenosis was noted and the clinical status significantly improved (Fig. 3 A, B).

Bottom Line: 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.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.

View Article: PubMed Central - PubMed

Affiliation: "Niculae Stăncioiu" Heart Institute, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

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.

No MeSH data available.


Related in: MedlinePlus