Dizziness and syncope after subclavian steal: A case report of a rarely symptomatic, common vascular disorder

Abstract

Subclavian steal syndrome (SSS) is a manifestation of vertebrobasilar artery insufficiency due to stenosis of the proximal subclavian artery. It is a common vascular disorder; however, most patients are asymptomatic, and the disorder is commonly found incidentally during imaging. Nevertheless, some patients may present with arm ischemia or signs and symptoms of vertebrobasilar insufficiency, such as vertigo, dizziness, diplopia, ataxia, dysarthria, and syncopal episodes. We present a case of a male patient who presented with sudden onset dizziness, syncopal episodes, and blood pressure discrepancy between his arms. Diagnosis was a challenge, and the patient underwent several investigations, including basic bloodwork, electrocardiography (ECG), echocardiography, brain computed tomography (CT), and coronary CT angiography (CTA). Narrowing in the proximal left subclavian artery was found during coronary CTA, which confirmed the diagnosis of SSS.