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coronary steal

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coronary steal
Cardiology A condition characterized by shunting of all relatively well oxygenated blood from a critical area of low perfusion, to an area of higher perfusion; it is unique as it may be iatrogenic and occur in pharmacologic stress imaging–see there, using dipyridamole to induce vasoconstriction; this causes a fall in blood flow to the subendocardium distal to the site of the stenosed coronary artery. See Steal. Cf Subclavian steal.


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Coronary steal is particularly evident during times of stress and can result in myocardial ischemia to territories not supplied by the arterial fistula.
Most patients with coronary artery fistulae remain asymptomatic, but some may have angina pectoris and, rarely, myocardial ischemia, which is related to coronary steal phenomenon.
Inhalation-based anesthetic techniques had been shown to be a key for early extubation in cardiac surgical patients, but the use of inhalation anesthetics in patients with coronary artery disease was questioned as isoflurane was proclaimed to be a powerful coronary vasodilator causing coronary steal.
 
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