Final answer:
Isoflurane is the inhalational anesthetic associated with coronary steal, a condition that may exacerbate ischemia in patients with compromised coronary arteries due to the diversion of blood to healthier vessels.
Step-by-step explanation:
The inhalational anesthetic that is associated with coronary steal is Isoflurane. Coronary steal refers to the phenomenon where blood flow is diverted from stenotic coronary arteries to healthy ones, potentially worsening ischemia in the compromised regions.
Coronary steal happens because some inhalational anesthetics can cause dilation of arterial vessels. Isoflurane, in particular, can cause peripheral and coronary vasodilation. This may lead to a redistribution of blood flow in the heart, away from areas that are already compromised due to stenosis, and towards areas with better blood supply. The areas with stenotic vessels receive less blood, which could potentially worsen ischemic conditions. Although the exact mechanism of isoflurane-induced coronary steal is complex and involves arteriolar resistance and the coronary vascular bed, this explanation simplifies the overall concept. Therefore, in patients with pre-existing coronary artery disease, careful consideration is needed when using isoflurane for anesthesia to mitigate the risks associated with coronary steal syndrome.