Yvette (54) a journalist from Kent, started experiencing pain in her hip seven years ago in 2015. An ex-national gymnast who had been incredibly active and flexible her whole life, Yvette felt concerned about the growing discomfort impacting her quality of life, and so sought help from her GP.
Coronary artery chronic total occlusion
ALSO KNOWN AS CTO
A CTO is a complete (or almost complete) blockage of a coronary artery for three months or more
What is CTO?
Coronary artery disease is a narrowing of the arteries in your heart due to a fatty build-up called plaque. This restricts the blood flow to your heart, and leads to symptoms like angina or, in serious cases, a heart attack. If an artery is totally blocked for more than three months it's known as a CTO.
Need to know
If you have coronary heart disease, including CTO, you may not have any symptoms. The most common symptom is chest pain or angina, which is a heaviness, tightness or dull pain in the chest, usually related to exercise.
The feeling can radiate through your left arm, back or neck. Other symptoms may include palpitations, shortness of breath, feeling very tired and nausea.
The feeling can radiate through your left arm, back or neck. Other symptoms may include palpitations, shortness of breath, feeling very tired and nausea.
If your GP or consultant thinks you may be at risk of cardiovascular disease, including CTO, they will speak to you about any symptoms you have and ask about your medical background, lifestyle and family history of heart disease. They may do a blood test to check your cholesterol levels. Other tests for CTO may include:
- an electrocardiogram (ECG) to measure the electrical activity of your heart
- an echocardiogram to visualise the valves and chambers of your heart
- a myocardial perfusion scan to look at your heart's blood flow pattern
- an invasive or non-invasive coronary angiogram to examine the heart arteries and the extent of any narrowing or blockage
Traditionally, patients with symptoms related to a CTO would have open heart coronary artery bypass graft surgery. Now, CTO can often be treated with minimally invasive techniques.
Many of our experienced cardiac consultants specialise in angioplasty, which involves accessing the coronary arteries by threading a thin, flexible tube (catheter) into the heart through a vein in your wrist or groin, and using tiny surgical instruments to remove blockages or widen a narrowed artery with a stent. Your consultant will let you know your treatment options and help to determine the best approach for you.
Many of our experienced cardiac consultants specialise in angioplasty, which involves accessing the coronary arteries by threading a thin, flexible tube (catheter) into the heart through a vein in your wrist or groin, and using tiny surgical instruments to remove blockages or widen a narrowed artery with a stent. Your consultant will let you know your treatment options and help to determine the best approach for you.
Patient stories
Yvette's story: From back pain to hip replacement surgery
A new hip and straight back into the spin of things
David’s gym video shows him repeatedly pushing up to 100kg on a single leg press – not particularly unusual for this keen cyclist, former competitive squash player and all-round fitness enthusiast. What is unusual is that 52-year-old David had hip surgery just 12 weeks earlier.
Michael's MAKO hip surgery to treat his arthritis
73 year-old Michael, an avid walker and charity worker, was diagnosed with arthritis in January 2021. After facing long waiting times and increasing pain that was becoming more frequent, he started to look elsewhere for treatment.
This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.