Coronary Subclavian Steal Syndrome Presenting as Acute Angina in a Postcoronary Artery Bypass Patient: An Unusual Case Report

• DOI: 10.4103/ijcr.ijcr_36_24
• Publication Date: 2024-11-29T16:00:08Z
• Authors: Rakesh Kumar Jha; Anshul Prakash Gupta; Subramaniam Anand; Rohit Dutta

Abstract “Coronary subclavian steal syndrome (CSSS)” refers to a clinical condition, exclusively seen in postcoronary artery bypass graft (CABG) patients, in whom the left internal mammary artery (LIMA) has been used as a native graft to bypass the coronary lesion and to supply the left anterior descending artery. If such patients develop critical stenosis of the subclavian artery proximal to the LIMA graft, there is a reversal of blood flow in the LIMA graft, leading to reduction in the territorial blood supply of the heart. This results in stable or unstable angina, myocardial infarction, and even sudden cardiac death. Considering the seriousness of CSSS, early diagnosis and timely management are warranted to prevent future complications. Hereby, we report a case of the post-CABG patient, who was initially admitted under cardiology care with acute coronary syndrome, later on, diagnosed as CSSS, and managed successfully by percutaneous endovascular intervention.