Portal de Periódicos da CAPES

Subclavian steal syndrome presenting as recurrent pulmonary oedema associated with acute left ventricular diastolic dysfunction

2012; Elsevier BV; Volume: 14; Issue: 1 Linguagem: Inglês

10.1016/j.carrev.2012.08.009

1553-8389

Giuseppe Mangialavori, Piercarlo Ballo, Stefano Michelagnoli, Leonardo Ercolini, Enrico Barbanti, Franco Passuello, Alessandro Abbondanti, Lorenzo Consoli, Tania Chechi, Veronica Fibbi, M Nannini, Leandro Chiodi, Alfredo Zuppiroli,

Cardiovascular Function and Risk Factors

Subclavian steal syndrome typically presents as angina in patients with internal mammary artery grafts. Atypical clinical presentations have been rarely described. We report an unusual case of subclavian steal syndrome presenting as pulmonary oedema with acute left ventricular diastolic dysfunction and preserved ejection fraction in a patient with internal mammary artery graft and severe stenosis of the proximal left subclavian artery. After successful angioplasty and stenting of subclavian artery, the patient remained asymptomatic for six months, but then experienced acute diastolic dysfunction and recurrent pulmonary oedema associated with critical subclavian in-stent restenosis with stent deformation. This report points out that, in patients with internal mammary-to-LAD grafts, subclavian steal syndrome may present as acute left ventricular diastolic dysfunction and pulmonary oedema even in the presence of normal ejection fraction.