Coronary-subclavian steal syndrome presenting with chest pain and syncope

The present case is a 68-year-old patient with complaints of chest pain and syncopal attacks during physical activity of the left arm, for the last six months. He had a coronary artery bypass graft operation 10 years ago. Angiographic examination demonstrated total occlusion of the subdavian artery. The subdavian artery was stealing blood from the left anterior descending artery via the left internal mammary artery and from the brain via the left vertebral artery, leading to the diagnosis of subdavian artery steal syndrome; a rare cause of coronary and cerebral ischaemia.