Hippocratic Sloth Presents: Subclavian Steal for the USMLE
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Short review of subclavian steal for the USMLE.
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Hippocratic Sloth Presents: Subclavian Steal for the USMLE
- 1. Hippocratic Sloth Presents: Subclavian Steal for the USMLE
- 2. Pathophysiology • Occlusion of proximal subclavian artery • Vertebral artery supplies retrograde flow • Posterior brain receives decreased blood flow
- 4. Epidemiology • 55 years + • Men > women more than 2:1 • Left subclavian affected 3x more often than Right
- 5. Risk Factors • Similar to Cardiac Risk Factor – Hypertension – Smoking – Diabetes Mellitus – Hyperlipidemia • Vigorous Exercise of affected arm
- 6. Causes • Arteriosclerosis of subclavian artery (95% of cases) • Embolism • Dissecting aortic aneurysm • Takayasu's Arteritis
- 7. Symptoms Vertebrobasilar Insufficiency • Light-headedness or Dizziness • Ataxia or Vertigo • Visual disturbance • Headache • Syncope • Confusion • Focal Seizure • Aphasia
- 8. Symptoms Subclavian Insufficiency (onset after CNS symptoms) • Arm weakness • Arm coldness, numbness or tingling • Arm Claudication with Exercise
- 9. Symptoms Provocative Maneuvers • Vigorous Exercise of affected arm • Sudden turning of head to affected side
- 10. Signs • Diminished radial and ulnar pulses in affected arm • Blood Pressure difference >20 mmHg between arms • Subclavian bruit • Radial pulse disappears with arm elevation or exercise
- 11. Radiology • Carotid Ultrasound • Magnetic resonance angiography • Arch Aortography
- 12. Management: Surgical Options • Axillo-axillary bypass • Carotid-Subclavian bypass • Percutaneous transluminal Angioplasty with stenting
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- Give a brief overview of the presentation. Describe the major focus of the presentation and why it is important. Introduce each of the major topics. To provide a road map for the audience, you can repeat this Overview slide throughout the presentation, highlighting the particular topic you will discuss next.
- Give a brief overview of the presentation. Describe the major focus of the presentation and why it is important. Introduce each of the major topics. To provide a road map for the audience, you can repeat this Overview slide throughout the presentation, highlighting the particular topic you will discuss next.
- Give a brief overview of the presentation. Describe the major focus of the presentation and why it is important. Introduce each of the major topics. To provide a road map for the audience, you can repeat this Overview slide throughout the presentation, highlighting the particular topic you will discuss next.
- Give a brief overview of the presentation. Describe the major focus of the presentation and why it is important. Introduce each of the major topics. To provide a road map for the audience, you can repeat this Overview slide throughout the presentation, highlighting the particular topic you will discuss next.
- Give a brief overview of the presentation. Describe the major focus of the presentation and why it is important. Introduce each of the major topics. To provide a road map for the audience, you can repeat this Overview slide throughout the presentation, highlighting the particular topic you will discuss next.
- Give a brief overview of the presentation. Describe the major focus of the presentation and why it is important. Introduce each of the major topics. To provide a road map for the audience, you can repeat this Overview slide throughout the presentation, highlighting the particular topic you will discuss next.
- Give a brief overview of the presentation. Describe the major focus of the presentation and why it is important. Introduce each of the major topics. To provide a road map for the audience, you can repeat this Overview slide throughout the presentation, highlighting the particular topic you will discuss next.
- Give a brief overview of the presentation. Describe the major focus of the presentation and why it is important. Introduce each of the major topics. To provide a road map for the audience, you can repeat this Overview slide throughout the presentation, highlighting the particular topic you will discuss next.
- Give a brief overview of the presentation. Describe the major focus of the presentation and why it is important. Introduce each of the major topics. To provide a road map for the audience, you can repeat this Overview slide throughout the presentation, highlighting the particular topic you will discuss next.