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Subclavian steal syndrome occurs when the artery that supplies blood from the heart to the brain becomes blocked, causing a reversal of blood flow. Symptoms include dizziness, vision problems, and numbness in the arms. Surgery is often required to treat the condition.
Subclavian steal syndrome is a condition in which the artery that normally pumps blood from the heart to the brain becomes narrowed or blocked, leading to a reversal in the direction of blood flow. Lack of blood supply to the brain can cause dizziness, vision problems, numbness in the arms and fainting spells. Subclavian steal syndrome is usually caused by buildups of calcium and cholesterol in the arteries, although blood clots or birth defects can also cause problems. In most cases, patients have to undergo surgical procedures to reopen or bypass the affected arteries.
The usual site of blockage or constriction is the left subclavian artery, a branch of the aortic arch that extends upward to the neck. Normally, the subclavian artery supplies blood to a vertebral artery, where it is carried to a system of blood vessels in the brain. In the case of subclavian steal syndrome, a blockage reverses blood flow in the vertebral artery so that the brain doesn’t get enough new blood.
Most people diagnosed with this condition have a pre-existing condition called atherosclerosis, in which cholesterol and fat build up and harden in the arteries. A blood clot or direct chest trauma can also constrict and damage the subclavian artery. Rarely, a baby can be born with a birth defect that isolates the subclavian artery from the rest of the heart and circulatory system, making it unable to receive and transport blood.
The most common symptoms of subclavian steal syndrome are blurred vision, dizziness, and nausea. Decreased blood pressure in the upper body can make the left arm go numb and reduce an individual’s ability to concentrate. It is also possible for a person to pass out or have a stroke if blood supply to the brain is severely restricted.
A cardiovascular doctor can diagnose subclavian steal syndrome by analyzing your symptoms and conducting a series of imaging tests. Ultrasounds, computed tomography, and chest X-rays can reveal the exact site of a blockage or the extent of the artery’s constriction. After making a diagnosis and identifying the underlying cause, your doctor can determine the best course of treatment. Most cases of subclavian steal syndrome do not respond to medical care, and individuals usually need to have surgery.
Depending on the type and severity of a blockage, a cardiovascular surgeon may try manually removing fatty deposits, inserting a stent into the damaged artery, or performing a bypass procedure. When stenting is needed, the surgeon inserts a hollow tube to make sure the artery keeps its shape. A bypass involves redirecting blood flow around the subclavian artery with a donor or artificial tube. After treatment, a patient usually needs to limit their physical activity and have regular checkups with a cardiovascular doctor to make sure problems don’t recur.
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