coronary steal


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cor·o·nar·y steal

a steal caused by anomalous origin of the coronary artery from the pulmonary artery.

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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CAF can result in coronary steal and left-to-right shunt which may further reduce the ventricular perfusion and increase diastolic volume overload.
Early surgical interventions are advised to correct the coronary steal syndrome and myocardial ischemia, and therefore establish a two coronary perfusion system that is mandatory for long-term survival.
In CAF, blood diverting from the high resistance myocardial capillary bed into the low resistance fistula produce ischemia and coronary steal phenomenon 30.
For example, the statement "Perhaps the most striking example is the rise and fall of high-dose opioid anesthesia, which was initially driven by concern about excessive cardiac depression by volatile anesthetics in the 1970s and further accelerated in the mid 1980s by concerns about potential coronary steal with isoflurane".
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.
Prestenotic vasodilation--especially isoflurane diverts blood away from ischaemic areas precipitating coronary steal phenomenon.
However, there have been several reports of coronary steal, particularly in patients with an extremely high-flow AV fistula.
Collaterals may develop between the right and left coronary system resulting in reversal of left coronary artery flow on account of low pulmonary vascular resistance which is often referred as coronary steal phenomenon.
Symptoms usually occur due to coronary steal phenomenon caused by the flow of blood from the higher pressure coronary arterial system to the lower pressure pulmonary arteries.
The anterior wall ischemia that was shown on nuclear stress imaging, chest pain and dynamic ST segment changes might be attributed to coronary steal phenomenon.