Subclavian steal syndrome: A review

Abstract

The incidence of subclavian steal syndrome is poorly documented in recent literature; however, there is general agreement that it is a relatively uncommon diagnosis. The actual occurrence of a subclavian steal is more common than the associated syndrome. Symptoms of arm ischemia and vertebral-basilar insufficiency secondary to a subclavian steal can become quite disabling in some patients. Through astute observation and assessment, nurses may be the first to identify a patient with subclavian steal syndrome. Subclavian steal may be identified by nurses during routine history and physical examination. All patients initially seen with discrepant arm blood pressures or a diminished or weakened radial pulse unilaterally should have the diagnosis of subclavian steal considered during their evaluation. In addition, patients with vertebral-basilar symptoms or arm ischemia should have the diagnosis of subclavian steal ruled out. This article presents a review of the history, pathogenesis, current treatment modalities, and nursing care of patients with a subclavian steal.