Syncope as a manifestation of subclavian steal syndrome in an elderly patient with congestive heart failure

SSS in an uncommon cause of syncope. Currently there is no, to the best of our knowledge, published English-language literature on the association between innominate artery stenosis and congestive heart failure, but we assume that a reduction in ejection fraction could precipitate a subclavian steal, leading to vertebrobasilar insufficiency. This case report underlines the importance of suspecting a SSS in patients with congestive heart failure and cerebrovascular disease, especially if clinicians detect a difference in systolic brachial blood pressure, measured in the two arms.