Subclavian Steal Syndrome

Subclavian Steal Syndrome

Subclavian steal syndrome describes a temporary or chronic partial or complete blockage of the arteries that supply blood to the brain and upper extremities.

What is Subclavian Steal Syndrome?

Subclavian steal syndrome is reduced blood flow to the arteries that supply blood to the upper extremities and brain. For femoral head necrosis in English, please visit gradphysics.com.

On the left, the upper area of ​​the shoulder girdle artery, the so-called subclavian artery, is affected. This case occurs more frequently. On the right side there are circulatory disorders in the truncus brachiocephalicus. The circulatory disorder is caused by temporary blockages or severe narrowing of the artery.

This can lead to serious illnesses, which is why subclavian steal syndrome must be treated. At best, a healthy lifestyle prevents the diseases that lead to subclavian steal syndrome.

Causes

When subclavian steal syndrome occurs, it can have several causes. On the one hand, a subclavian steal syndrome can be caused by arteriosclerosis.

Arteriosclerosis describes a disease in which deposits of blood fats, connective tissue, thrombi and small amounts of calcium in the arteries occur. Arteriosclerosis is therefore also popularly referred to as hardening of the arteries.

Another possible cause of subclavian steal syndrome is Takayasu’s arteritis, an autoimmune disease that leads to inflammation of the aorta, which in the worst cases ends in destruction of the vessel walls.

Symptoms, Ailments & Signs

Subclavian steal syndrome is characterized by both neurological and arm-related symptoms. However, the entire symptomatology depends on the extent of the decrease in blood flow through the arteries supplying the brain. There are asymptomatic, paroxysmal and continuous forms of the disease.

When the flow dynamics in the brachial artery are normal, there are no symptoms. In cases of short-term interruption of the blood flow, there is a sudden symptomatology that starts with arm movements. In some patients, the blood flow through the arteries supplying the brain is permanently reduced. This leads to chronic complaints.

The neurological symptoms are characterized, among other things, by seizures of dizziness and seizures of unconsciousness. Sudden falls while fully conscious are also possible. There is a loss of tone in the lower extremities. As part of the neurological deficits, visual disturbances, ringing in the ears, sensitivity disorders, coordination disorders of movement or speech and swallowing disorders are also observed.

In addition to the neurological deficits, there are often arm-related symptoms, which usually only appear on one side. These affect the arms and show up there in the form of paresthesia (tingling, numbness), paleness, feelings of cold and pain. Most of the time, only some of the symptoms occur. Only in severe forms of the disease does the patient suffer from all symptoms permanently. The symptoms often increase with arm movements.

Diagnosis & History

When subclavian steal syndrome is accompanied by a short-term interruption in blood supply, there are usually asymptomatic abnormalities, which complicate the diagnosis of subclavian steal syndrome.

However, if a permanent subclavian steal syndrome occurs, neurological deficits such as sudden dizziness up to fainting spells, sensory disturbances, visual disturbances and minor strokes confirm the suspicion of subclavian steal syndrome.

In the arms, there is also a slight tingling or itching to severe pain. The arms also often lose color and feel cold. When these symptoms occur and subclavian steal syndrome is suspected, a doctor can diagnose subclavian steal syndrome through a comprehensive medical history followed by an extensive physical examination.

Blood pressure and pulse as well as flow noises provide the first indications. Subclavian steal syndrome can then be clearly diagnosed with imaging procedures such as duplex sonography or angiography. If left untreated, subclavian steal syndrome can result in minor to severe strokes that can be fatal.

Even if death does not occur as a result of not treating the subclavian steal syndrome, serious damage and disabilities are possible if the brain is not supplied with sufficient blood and therefore also with oxygen for too long as a result of the circulatory disorders. At the slightest sign of subclavian steal syndrome, it is therefore important to consult a doctor so that he can either rule out subclavian steal syndrome or start appropriate treatment immediately.

Complications

In the worst case, subclavian steal syndrome can lead to death in those affected. However, this only occurs if the disease is not treated. Those affected primarily suffer from severe dizziness and also from unconsciousness. It comes to ringing in the ears and also to various visual disturbances, which, however, only occur temporarily.

Sensitivity disorders and paralysis can also occur in subclavian steal syndrome and have a very negative effect on the patient’s quality of life. It also continues to cause pain and pallor in those affected. Those affected often freeze with subclavian steal syndrome and also suffer from tingling in the extremities. If the disease is not treated in time, the internal organs can also be damaged.

The patient’s life expectancy may also be reduced by the syndrome. In the treatment of this disease, as a rule, there are no special complications. The symptoms can be alleviated with the help of surgical interventions. Subsequent treatment with medication is also usually necessary for subclavian steal syndrome. Furthermore, a healthy lifestyle has a very positive effect on the disease and can prevent further symptoms.

When should you go to the doctor?

In the case of subclavian steal syndrome, the person affected definitely needs to see a doctor. This disease cannot heal itself, although if left untreated, the symptoms worsen significantly and, in the worst case, can even lead to the death of the person affected. Therefore, at the first symptoms and signs of subclavian steal syndrome, a doctor should be consulted to prevent further complications.

A doctor should be consulted if the person concerned suffers from sudden severe dizziness. It can even lead to a loss of consciousness. Furthermore, disturbances in sensitivity or problems with swallowing indicate subclavian steal syndrome and should be examined by a doctor immediately. A severe paleness or a permanent feeling of cold often indicate this disease. Many sufferers also experience sudden visual problems.

Subclavian steal syndrome should usually be treated immediately by an emergency doctor or in a hospital. In some cases, the person concerned can first consult a general practitioner or a cardiologist. Whether subclavian steal syndrome will lead to a reduced life expectancy cannot be universally predicted.

Treatment & Therapy

Subclavian steal syndrome is treated depending on the accompanying symptoms. A slight vasoconstriction can be corrected by a so-called angioplasty. The vessels are widened again by so-called balloon catheters, which are often inserted into the vessels via the groin.

In addition, so-called stents are often placed in the affected vessel. These stretchable metal or plastic tubes also ensure that the blockage is removed and the vessel can be supplied with sufficient blood again. In the case of severe vasoconstriction, on the other hand, a surgical intervention is often necessary, in which a bypass is set. This is an artificial bypass of the vascular section in which the vasoconstriction is present.

Prevention

To prevent subclavian steal syndrome, all diseases that can result in arterial occlusion must be prevented.

A healthy diet and a healthy lifestyle are particularly effective. Smoking, in particular, can clog arteries, disrupt or completely stop blood flow, and lead to subclavian steal syndrome.

Other risk factors that favor subclavian steal syndrome and should therefore be avoided are an excessively high-fat diet and being overweight, high blood pressure and high cholesterol. A low-fat diet with sufficient exercise is therefore also a good way to prevent subclavian steal syndrome.

Aftercare

Since the subclavian steal syndrome is a congenital and therefore also genetic disease, it cannot usually heal on its own. Those affected are therefore dependent on examination and treatment by a doctor. The measures and the options for aftercare are usually significantly limited.

Early diagnosis can prevent further symptoms and complications from occurring. If the affected person or the parents wish to have children, a genetic examination and counseling is recommended in order to prevent the recurrence of this disease. The treatment of subclavian steal syndrome is usually carried out by means of physiotherapy or physiotherapy.

Those affected can also repeat many of the exercises at home and thus accelerate healing. Regular check-ups and examinations by a doctor are also very useful in order to monitor the symptoms permanently. The subclavian steal syndrome usually does not limit the life expectancy of the person affected. Contact with other people affected by the disease can also be very useful, as this can lead to an exchange of information, which makes everyday life easier for those affected.

You can do that yourself

Subclavian steal syndrome usually requires invasive treatment. However, those affected can also take some measures themselves to alleviate the underlying circulatory disorders.

The first thing to do is change your lifestyle. Patients are not allowed to smoke or drink and must eat a low-fat, balanced diet. It is also important to exercise regularly to stimulate blood circulation in the limbs. In case of numbness or other signs of circulatory disorders, the doctor should be informed. After an intervention in which, for example, a bypass is placed or the condition is invasively removed, rest and protection are the order of the day. It is best for the patient to talk to the attending physician about the important measures to be taken. If symptoms appear again that indicate further circulatory disorders, the doctor must be informed.

The risk of an artery occlusion can be further reduced by accompanying measures such as massages or exercise. However, since subclavian steal syndrome is a serious condition, close medical monitoring is always required. Patients must consult their general practitioner and an internist, especially if a bypass has been placed.

Subclavian Steal Syndrome