Abstract Body

Peripheral arterial disease (PAD) affects about 3 to 10% of general population and 15 to 20% of individuals over 70 years (NORGREN, L. et al, 2007). PAD results in most cases of atherosclerotic obstruction of the arterial lumen.

Despite the fact that the lower limbs are the most common location, and for this reason are most frequently researched and diagnosed, it is important to be aware of other clinical manifestations of PAD. Subclavian artery stenosis, mainly on left side, occurs in about 2% of general population and in 15% of patients over the age of 70 (Shannon Caesar-Peterson 2020). Its diagnosis is essential to avoid the associated complications that range from limb claudication, to cerebral hypoperfusion and stroke.

Our case reports a 73-year-old man chronic smoker with a medical history of gastric ulcer and psoriasis, whose chief complaint was several episodes of hypotension, associated with daily dizziness, hyposthesia of the left upper limb and chest pain. After a careful cardiovascular examination, a blood pressure differential was detected between the upper limbs and the subsequent imaging study revealed the presence of left subclavian artery stenosis. The patient was subsequently referred to vascular surgery and was submitted to left subclavian artery stenting.

This case highlights a rare cause of hypotension so that subclavian artery stenosis is a diagnosis which family doctors have to be aware of.