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A Case of Bilateral Subclavian Artery Stenosis Presenting as Refractory Hypotension
Journal article   Open access

A Case of Bilateral Subclavian Artery Stenosis Presenting as Refractory Hypotension

Taisuke Shibata, Kohei Ukai, Takaaki Kobayashi, Sandra Moody, Akihito Yoshida and Tadashi Eguchi
Annals of Internal Medicine: Clinical Cases, Vol.2(1), e220785
01/01/2023
DOI: 10.7326/aimcc.2022.0785
url
https://doi.org/10.7326/aimcc.2022.0785View
Published (Version of record) Open Access

Abstract

A 72-year-old woman presented with epigastric pain, hypotension, and tachycardia. Laboratory studies revealed anemia and lactic acidosis. Endoscopy showed gastric cancer without active bleeding. Although the tachycardia and lactic acidosis resolved shortly after a blood transfusion, her blood pressure (BP) remained low. BP measured in both her upper and lower extremities confirmed a discrepancy. Computed tomography revealed findings suggestive of bilateral subclavian artery stenosis. Bilateral subclavian artery stenosis should be suspected in a patient who presents with prolonged unexplained asymptomatic low BP measured in both upper extremities, noting the importance of also measuring the BP in all extremities.

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