title: Subclavian steal syndrome in acute myocardial infarction masquerading as acute embolism to left upper extremity-a case report.
abstract: Subclavian steal syndrome is an uncommon entity diagnosed with angiography after neurologic symptoms occur during activity with the upper extremity. Cardiac symptoms or silent ischemia have been described in patients who have undergone cardiac bypass using the ipsilateral internal mammary artery. Our patient presented with acute chest pain radiating to the left upper extremity and a diminished pulse. Angiography to rule out an acute embolus instead revealed subclavian artery occlusion. As atherosclerosis is the most common cause, the ipsilateral subclavian artery should be carefully evaluated, particularly in cardiac patients undergoing coronary angiography. Recognition of coexisting subclavian artery occlusion could prevent cardiac complications that may occur with use of the ipsilateral internal mammary artery during coronary artery bypass surgery.
authors.affiliation: New York Methodist Hospital, Brooklyn, NY 11215, USA. en03@hotmail.com
authors.forename: Ian K
authors.initials: IK
authors.lastname: Komenaka
authors.forename: Eric T
authors.initials: ET
authors.lastname: Nguyen
authors.forename: Sylvanus O
authors.initials: SO
authors.lastname: Oyogoa
authors.forename: John B
authors.initials: JB
authors.lastname: DeGraft-Johnson
authors.forename: Syed Q
authors.initials: SQ
authors.lastname: Gardezi
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004617:Embolism / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging*; D011859:Radiography; D013349:Subclavian Steal Syndrome / Q000150:complications* / Q000000981:diagnostic imaging*; D034941:Upper Extremity / Q000098:blood supply* / Q000000981:diagnostic imaging