Simultaneous coronary - subclavian and vertebral - subclavian steal syndrome.
Atherosclerotic disease of the coronary artery may simultaneously involve the subclavian artery, and a significant stenosis of the left subclavian artery may result in recurrent myocardial ischemia in patients with patent left internal mammary artery (LIMA) grafts because of 'coronary steal' through the LIMA. Isometric exercise of the left arm may improve myocardial perfusion through vertebral - subclavian steal by flow reversal in the ipsilateral vertebral artery because of the change in the pressure gradient between the circle of Willis and the distal subclavian artery. The present patient had coronary steal through a LIMA after coronary artery bypass surgery and a transient vertebral - subclavian steal with improved myocardial perfusion as a result of exercise of the left arm.
Lee
Sang Rok
SR
The Heart Center, Chonnam National University Hospital and Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.
Jeong
Myung Ho
MH
Rhew
Jay Young
JY
Ahn
Young Keun
YK
Na
Kook Joo
KJ
Song
Ho-Cheun
HC
Bom
Hee Seung
HS
Cho
Jeong Gwan
JG
Ahn
Byoung Hee
BH
Park
Jong Chun
JC
Kim
Sang Hyung
SH
Kang
Jung Chaee
JC
D019797:3-Iodobenzylguanidine; D001921:Brain / Q000000981:diagnostic imaging*; D003327:Coronary Disease / Q000175:diagnosis*; D015444:Exercise; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013349:Subclavian Steal Syndrome / Q000000981:diagnostic imaging*
D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine