Coronary subclavian steal syndrome: a rare cause of acute myocardial infarction

Tan JWC, Johan BA, Cheah FK, Wong P
Correspondence: Dr Jack WC Tan, jacktanwc@gmail.com

ABSTRACT
The coronary subclavian steal syndrome (CSSS) leading to an acute myocardial infarction (AMI) post-coronary bypass is a rare occurrence. We describe an 83-year-old Indian man who presented with AMI and was subsequently found to have CSSS. The patient had severe stenosis of his left subclavian artery ostium with retrograde flow up his left internal mammary artery graft. Angiographical steal from the left anterior descending artery was demonstrated during coronary angiogram and was thought to be the main contributing cause of his AMI. Percutaneous transfemoral angioplasty and stent implantation was performed to the left subclavian artery, with resolution of myocardial blood flow steal and anterior ischaemia.

Keywords: coronary stent, coronary subclavian steal syndrome, ischaemic heart disease, myocardial infarction, percutaneous transfemoral angioplasty
Singapore Med J 2007; 48(1): e5–e8