Bilateral Subclavian Steal Syndrome
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Introduction
Subclavian steal syndrome was first described by Contorni in an asymptomatic patient in 1960 and was subsequently associated with potential for cerebrovascular symptoms. It is usually due to reversal of vertebral blood flow in the setting of proximal subclavian or innominate artery severe stenosis or occlusion. This often results in cerebral ischemia related to exercise of the upper extremities. Subclavian stenosis can be easily diagnosed by comparing bilateral brachial systolic blood pressures (>15?mmHg difference) and is an independent risk factor of overall and cardiovascular mortality. Subclavian steal typically occurs only in the setting of severe stenosis or occlusion. Bilateral subclavian steal syndrome is a rare condition.

Case Report
Fifty-eight-year-old female presented to our center with progressive shortness of breath and fatigue over the past month. Shortness of breath was mainly with exertion and had been progressive. She reported sleeping on five pillows and had required oxygen therapy at night for the last 1.5 years but denied paroxysmal nocturnal dyspnea. She denied pain in the arms with exertion or lightheadedness when using her arms....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008275/
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