Our Summary

This research paper discusses a rare case where a 69-year-old man who had previously undergone a heart bypass surgery developed a condition known as Coronary Subclavian Steal Syndrome (CSSS). This condition is a complication of the bypass surgery and caused the man to experience pain in his left arm and angina (chest pain). Using advanced imaging techniques, the doctors discovered a severe blockage in the main artery in his left shoulder. The paper reports that the doctors successfully treated the man’s condition by removing the blockage in his shoulder artery, without needing to use a stent (a tube inserted into a blocked passageway to keep it open). This case shows that this method can be an effective treatment for CSSS, especially in patients who had heart bypass surgery in the past.

FAQs

  1. What is Coronary subclavian steal syndrome and how is it related to CABG?
  2. What symptoms did the patient present that led to the diagnosis of Coronary subclavian steal syndrome?
  3. What treatment was used for the patient with Coronary subclavian steal syndrome in this case study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about CABG is to maintain a healthy lifestyle, including a balanced diet, regular exercise, and avoiding smoking. It is important to follow up with your healthcare provider regularly to monitor your heart health and make any necessary adjustments to your treatment plan. If you experience any new or worsening symptoms, such as chest pain or shortness of breath, it is important to seek medical attention promptly.

Suitable For

Patients who are typically recommended for CABG are those with significant coronary artery disease that cannot be effectively treated with medication or less invasive procedures such as angioplasty. These patients may have symptoms such as chest pain (angina) or shortness of breath, or may have had a heart attack. Patients with multiple blockages in their coronary arteries, or blockages in critical arteries that supply blood to the heart, are also often recommended for CABG. Additionally, patients who have previously undergone CABG and develop complications such as coronary subclavian steal syndrome may also be recommended for further intervention.

Timeline

Before CABG:

  • Patient experiences symptoms of coronary artery disease, such as chest pain (angina), shortness of breath, and fatigue.
  • Patient undergoes diagnostic tests such as electrocardiogram (ECG), stress test, and coronary angiography to confirm the presence and severity of blockages in the coronary arteries.
  • Based on the results of these tests, the patient is deemed a candidate for CABG surgery.
  • Patient undergoes pre-operative evaluation, including blood tests, imaging studies, and consultation with various healthcare providers.

After CABG:

  • Patient undergoes CABG surgery, during which bypass grafts are placed to reroute blood flow around blockages in the coronary arteries.
  • Patient is monitored closely in the intensive care unit (ICU) immediately after surgery to ensure proper healing and recovery.
  • Patient undergoes rehabilitation and physical therapy to regain strength and function after surgery.
  • Patient is discharged from the hospital and continues to follow up with their healthcare team for long-term management of coronary artery disease.
  • Patient may experience improvements in symptoms such as chest pain and shortness of breath, and may be able to resume normal activities and lifestyle with appropriate medical management.

What to Ask Your Doctor

  1. What is coronary subclavian steal syndrome and how is it related to my previous CABG surgery?
  2. What are the symptoms and potential complications of coronary subclavian steal syndrome?
  3. How is coronary subclavian steal syndrome diagnosed?
  4. What treatment options are available for coronary subclavian steal syndrome?
  5. What is the success rate of the treatment options for coronary subclavian steal syndrome?
  6. Are there any potential risks or side effects associated with the treatment for coronary subclavian steal syndrome?
  7. How long will it take to recover from the treatment for coronary subclavian steal syndrome?
  8. Will I need any follow-up appointments or monitoring after the treatment for coronary subclavian steal syndrome?

Reference

Authors: Gill H, Gill HS, Kotha V. Journal: Radiol Case Rep. 2022 Mar 5;17(5):1524-1527. doi: 10.1016/j.radcr.2022.02.032. eCollection 2022 May. PMID: 35282316