A Forgotten Cause of Chronic Dizziness in the Elderly: Exercise-Induced Vertebrobasilar Insufficiency due to Grade III Subclavian Steal Syndrome

Chronic dizziness in elderly patients, particularly when reproducibly triggered by upper limb exertion, should prompt evaluation for arm-exertion-provoked vertebrobasilar hypoperfusion due to subclavian steal syndrome. Duplex ultrasonography can identify complete retrograde vertebral artery flow and confirm complete Grade III subclavian steal physiology, highlighting a treatable vascular cause that may otherwise be...

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Audiologists and vestibular clinicians evaluating elderly patients with unexplained exercise-triggered dizziness should consider vascular causes such as subclavian steal syndrome and refer to cardiology/vascular surgery when suspected — this case reinforces differential diagnosis breadth but introduces no new audiology-specific protocol change.

This case highlights a vascular mimic of vestibular disorder that can be overlooked in elderly dizzy patients, reinforcing the importance of a broad differential diagnosis that includes non-inner-ear causes of chronic dizziness.

1. 01Grade III subclavian steal syndrome caused exercise-induced vertebrobasilar insufficiency presenting as chronic dizziness in an elderly patient.
2. 02The condition is underrecognized and can mimic inner-ear (vestibular) disorders.
3. 03Diagnosis requires vascular imaging; audiologic testing alone will not identify this cause.
4. 04Prompt vascular referral is essential to prevent serious complications such as stroke.
5. 05Published as a case report in Clinical Case Reports; DOI 10.1002/ccr3.73355.

PMID

42662235

DOI

10.1002/ccr3.73355.

Journal

Clinical Case Reports

Publication type

case_report

Evidence level

4

Sample size

1

Population

Elderly patient with chronic dizziness

Intervention

Diagnosis of grade III subclavian steal syndrome causing vertebrobasilar insufficiency