Key result
Doppler ultrasonography successfully identifies coronary subclavian steal syndrome presenting as VF prior to percutaneous angioplasty.
Why the study?
Coronary subclavian steal syndrome is a known cause of graft failure after LIMA-LAD grafting, but cases presenting with ventricular fibrillation have not been described.
Case Report (n=1)
Doppler ultrasound is an effective non-invasive modality for diagnosing coronary subclavian steal syndrome, even in atypical presentations such as ventricular fibrillation.
Suggests Doppler consideration in atypical VF; hypothesis-generating case report leaves validation to future studies.
Coronary subclavian steal syndrome (CSSS) is a well documented cause of graft function failure in patients after left internal mammary artery (LIMA)--left anterior descending (LAD) coronary artery grafting. We present a case of the CSSS in a patient with cardiac arrest due to ventricular fibrillation. To our knowledge such a case has not yet been described. Patient with a history of LIMA-LAD grafting, complaining only of a mild chronic exertional dyspnoea developed ventricular fibrillation while walking outdoor. After successful resuscitation, blood pressure difference between both arms and abnormal LIMA flow with systolic reversal flow on the Doppler ultrasonography were suggestive of CSSS. Angiography proved the left subclavian artery (LSA) occlusion and coronary angiography confirmed reversal flow in the LIMA graft. Successful percutaneous transluminal angioplasty of the LSA re-established normal LIMA flow and improved the left ventricular hypokinesis and systolic function.
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Večeřa et al. (2010) conducted a case report in Coronary subclavian steal syndrome (n=1). Doppler ultrasound and percutaneous transluminal angioplasty was evaluated on Diagnosis and treatment of coronary subclavian steal syndrome. Doppler ultrasonography successfully identified coronary subclavian steal syndrome in a patient presenting with ventricular fibrillation, which was subsequently treated with percutaneous angioplasty.
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