26 year old male with left upper extremity discomfort that occurred only when he was in an upright position and his arm was positioned over her head.
Comment: This patient only experienced symptoms when he was upright and his arm was positioned over his head. As a result, this angiogram was performed with the patient in an upright position on a tilt table. Once the catheter was in place within the left subclavian artery, the arm position was changed until the radial pulse was no longer palpated. At this point, the angiogram was performed, demonstrated the left subclavian artery stenosis.