BACKGROUND:
Recommendations of international societies as well as the Standard Diagnostic and Therapeutic Procedures for Arterial Hypertension in Slovakia explicitly recommend measuring blood pressure in both upper extremities. The symptomatic upper extremity peripheral artery disease is poorly studied compared with the lower extremity. Case report: We describe the case of an 87-year-old woman with arterial hypertension, dementia, and adenocarcinoma of the uterus, She was many times hospitalized for collapses in the last 10 years. The patient worked as a hairdresser her entire life. Her work was also her passion and hobby. She practically until nowadays does hairstyles for her friends and neighbors. The pain of her right shoulder was quite logically attributed to right-sided osteoarthritis. During last hospitalization in the long-term care department was it found that the pressure difference between the right and left arm was 40 mmHg. Color duplex sonography and CT angiography were performed. The examinations confirmed critical stenotization of the right subclavian artery with the presence of subclavian steal syndrome. Subsequently the vascular team attempted to patency the stenosed right subclavian artery, but the calcified lesion resisted. The patient was discharged to the nursing house. In the discharge report, the general practitioner was alerted to inter arm pressure difference, which he must take into account in the management of arterial hypertension. A follow-up examination is planned with consideration of further intervention

CONCLUSIONS:
The case is an example of the long-standing ignoring of the recommendation regarding measuring blood pressure in both arms. Health insurance companies in Slovakia reimburse preventive examinations every two years (blood donors every year). A self-evident part of the preventive examination should be measured in both arms. Similarly, during the first visit to the department or hospital, in case of difficulties - dizziness, headaches and shoulder pain, or collapses.