Explore a case of Angina triggered by arm exercise in a post-CABG patient. Discover how subclavian artery occlusion can “steal” blood from the heart.
A 63-year-old man with a history of coronary-artery bypass grafting presented with a 2-month history of angina that occurred during exertion of the left arm. Five years before presentation, he had undergone grafting of the left internal thoracic artery (LITA) to the left anterior descending (LAD) coronary artery. The blood pressure was 128/84 mm Hg in the right arm and unmeasurable in the left arm. On physical examination, the brachial and radial pulses on the left side were feeble. A computed tomographic angiogram of the aorta and neck vessels showed total occlusion of the subclavian artery on the left side, proximal to the origin of the LITA. Which of the following is the most likely diagnosis?
What is the most likely diagnosis?
Angina Pectoris, CABG, Coronary-Subclavian Steal Syndrome, LITA Graft, Subclavian Artery Stenosis
