ISSN 1016-5169 | E-ISSN 1308-4488
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Dunbar syndrome as an unusual cause of exercise-induced retrosternal pain [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2015; 43(5): 465-467 | DOI: 10.5543/tkda.2015.52563

Dunbar syndrome as an unusual cause of exercise-induced retrosternal pain

Yusuf Karavelioğlu1, Macit Kalçık2, Taner Sarak1
1Hitit University, Faculty Of Medicine, Department Of Cardiology, Çorum, Turkey
2İskilip Atıf Hoca State Hospital, Department Of Cardiology, Çorum, Turkey

The median arcuate ligament is a fibrous band connecting the left and right diaphragmatic crura across the aortic hiatus at the level of the T12/L1 vertebral bodies. The low insertion point of this ligament causes significant stenosis of the proximal portion of the coeliac artery in a small group of patients, and contributes to ischemic symptoms known as coeliac artery compression syndrome (CACS). It is also referred to as median arcuate ligament syndrome or Dunbar syndrome. Symptoms include especially postprandial epigastric or retrosternal pain, weight loss, nausea, vomiting, diarrhea and reduced appetite. In severe cases, exercise related abdominal pain may be caused by steal phenomenon, whereby blood is shunted to the skin and relevant muscles during exercise. Computed tomographic angiography and mesenteric angiography are the gold standard diagnostic modalities to confirm diagnosis of CACS. Surgical therapy with release of the median arcuate ligament usually is the primary treatment of choice. Here, we present a 46-year-old male CACS patient with postprandial and especially exercise- induced retrosternal pain radiating to the epigastric region, which may be misperceived as a coronary symptom.

Keywords: Coeliac artery/abnormalities, median arcuate ligament; computed tomography

How to cite this article
Yusuf Karavelioğlu, Macit Kalçık, Taner Sarak. Dunbar syndrome as an unusual cause of exercise-induced retrosternal pain. Turk Kardiyol Dern Ars. 2015; 43(5): 465-467

Corresponding Author: Macit Kalçık, Türkiye
Manuscript Language: English


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