CORONARY-SUBCLAVIAN THEFT SYNDROME AS A CAUSE OF UNSTABLE ANGINA

CASE REPORT

Abstract

Introduction: Coronary-subclavian steal syndrome is a rare condition associated with patients undergoing coronary artery bypass graft surgery. In this context, it presents itself as a differential diagnosis of angina, which when correctly diagnosed and treated can improve the outcome and avoid potential complications. Case report: Male patient, 65 years old, hypertensive, dyslipidemic, peripheral and coronary artery disease who underwent myocardial revascularization surgery in 2000 with mammary graft in an anterior descending artery. He was undergoing regular cardiological follow-up, asymptomatic from a cardiovascular point of view. In this first moment, ischemic test exams were performed, whose scintigraphy showed an 8% ischemic load and indicated catheterization with subclavian lesion with 70% in the origin and breast graft with preserved patency. About 6 months after this consultation, the patient returns with a complaint of stable angina. A new scintigraphy was performed whose ischemic load had increased, now by 12%. At this point, percutaneous treatment of the subclavian lesion was indicated, using a 9.0x25mm balloon-expandable stent successfully, with angiographic control performed with a PigTail catheter showing good results. On outpatient return, the patient showed a substantial improvement in anginal symptoms, confirmed on scintigraphy with a reduction in ischemic load to 5%. Conclusion: The above report describes a classic picture of subclavian theft syndrome, with presentation of precordialgia, showing that the rapid diagnosis of this rare condition and due treatment have the potential to improve the clinical scenario and myocardial perfusion.