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.
The Heart Center, Chonnam National University Hospital and Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.
Sang Rok
SR
Lee
Myung Ho
MH
Jeong
Jay Young
JY
Rhew
Young Keun
YK
Ahn
Kook Joo
KJ
Na
Ho-Cheun
HC
Song
Hee Seung
HS
Bom
Jeong Gwan
JG
Cho
Byoung Hee
BH
Ahn
Jong Chun
JC
Park
Sang Hyung
SH
Kim
Jung Chaee
JC
Kang
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