Congenital subclavian steal: Report of a case occurring in a neonate and review of the literature

Abstract

This report is a reminder that the congenital subclavian steal can occur in the newborn and can be diagnosed clinically. Increased awareness of the phenomenon has been partially responsible for the recognition of 26 cases since the first described in 1960. This would indicate that the entity is not as rare as previously thought. Careful palpation of both brachial pulses as well as the femorals should be performed in all newborns, especially in infants with a right aortic arch or coarctation of the aorta. A discernible brachial pulse discrepancy should alert the clinician to the possibility of a subclavian steal. While associated cardiovascular lesions are not uncommon, neurologic symptoms are infrequently seen in early childhood. Extensive extracranial collaterals and the absence of atherosclerosis are thought to be the main reasons for the lack of symptoms in childhood. Elective surgical intervention is, therefore, not usually necessary before the second decade.