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Coronary artery chronic total occlusion

CTO

A CTO is a complete (or almost complete) blockage of a coronary artery for three months or more

About

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

  • 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.

  • Diagnosis 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 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.
Consultant in theatres

Our consultants

We're proud to work with leading experts across a range of medical fields, whose skills are matched by their integrity and compassion. 

Our facilities

From complex surgery to straightforward procedures, we provide exceptional care across our network of hospitals, outpatient centres and specialist clinics.

  • London Bridge Hospital Facility

    London Bridge Hospital

    27 Tooley Street

    London

    SE1 2PR

    Appointments and Enquiries 020 7234 2009
    Imaging Appointments 020 7234 2773
    Switchboard 020 7407 3100

  • Wellington-south-hero-facility-582-582

    The Wellington Hospital

    Wellington Place

    London NW8 9LE

    Appointments 0207 483 5148
    Enquiries 020 3131 7478

  • facility-HSC-flag-hero-582x582

    The Harley Street Clinic

    35 Weymouth Street

    London

    W1G 8BJ

    Appointments 020 7034 8181
    Enquiries 020 3131 7962

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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