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

  • What are the symptoms of chronic total occlusion?  icon plus

    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.

  • How is CTO diagnosed?  icon plus

    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
  • Potential treatment options for CTO  icon plus

    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.

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This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
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