Manifestation of coronary subclavian steal phenomenon using reactive hyperemia in the ipsilateral forearm

Echocardiography. 2019 Oct;36(10):1956-1958. doi: 10.1111/echo.14485. Epub 2019 Oct 1.


Coronary subclavian steal syndrome (CSSS) is a coronary steal phenomenon secondary to subclavian artery stenosis in patients who have undergone coronary bypass surgery with the internal thoracic artery. Most commonly, CSSS is diagnosed angiographically. Our case emphasizes that stress ultrasound assessment using reactive hyperemia in the ipsilateral arm elicits a functional diagnosis of CSSS.

Keywords: coronary artery bypass grafting; flow-mediated dilation; left internal mammary artery; subclavian artery stenosis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Coronary Artery Bypass*
  • Coronary-Subclavian Steal Syndrome / complications*
  • Coronary-Subclavian Steal Syndrome / diagnostic imaging*
  • Coronary-Subclavian Steal Syndrome / physiopathology
  • Forearm / diagnostic imaging
  • Forearm / physiopathology
  • Humans
  • Hyperemia / etiology*
  • Hyperemia / physiopathology
  • Male
  • Postoperative Complications / diagnostic imaging*
  • Postoperative Complications / physiopathology
  • Ultrasonography / methods*