ST-Segment elevation acute myocardial infarction due to severe hypotension and proximal left subclavian artery stenosis in a prior coronary artery bypass graft patient.
Proximal subclavian artery stenosis may result in cardiac ischemia in coronary artery bypass graft patients with internal mammary grafts. We report a case of acute anterior myocardial infarction in such a patient who developed severe systemic hypotension. Symptoms and electrocardiographic changes resolved after proximal left subclavian artery stenting. Subclavian angiography should be considered in all prior coronary artery bypass graft patients with internal mammary grafts undergoing coronary angiography.
Dimas
Billy
B
VA North Texas Healthcare System, Dallas, TX 75216, USA.
Lindsey
Jason B
JB
Banerjee
Subhash
S
Brilakis
Emmanouil S
ES
D000328:Adult; D000787:Angina Pectoris / Q000209:etiology; D000800:Angioplasty, Balloon / Q000295:instrumentation; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007022:Hypotension / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012720:Severity of Illness Index; D015607:Stents; D013349:Subclavian Steal Syndrome / Q000150:complications / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome