Diagnostic and Treatment Algorithm in a Plurivascular Patient – Case Report

Abstract

Abstract Introduction: Atherosclerosis represents the main cause of arterial stenosis, mostly affecting the arteries of the lower extremities. Atherosclerotic arterial disease presents multiple localizations, including the carotid, subclavian, coronary, and kidney arteries. The severity of the stenosis does not always correlate with the symptomatology. Case report: We present the case of a patient with multisite atherosclerotic disease. A 70-year-old smoker male patient, with a history of myocardial infarction and renal artery stenosis, presented in the emergency department complaining of vertigo, chest pain, and intermittent claudication. The diagnostic and treatment algorithm represented a challenge. Imaging assessment showed atherosclerotic lesions in a new vascular territory, which involved the left subclavian artery with a stenosis of 70%. Conclusions: Subclavian artery stenosis can be a hidden form of atherosclerotic disease, often undiagnosed, which needs urgent interventional treatment and can be easily unmasked using simple tools such as measuring the blood pressure on both arms. Patients with athero-sclerotic lesions must undergo comprehensive screening for multisite atherosclerotic disease.