Chronic Total Occlusions


Chronic Total Occlusion (CTO) is complete or almost complete blockage of a coronary or peripheral artery for 30 or more days. Coronary CTO is caused by heavy buildup of atherosclerotic plaque within the arteries of the heart. Peripheral CTO is caused by heavy buildup of atherosclerotic plaque within the peripheral arteries of the legs or arms.

Signs & Symptoms

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If you have Coronary Artery Chronic Total Occlusion you may experience:

  • Angina or chest pain
  • Pain in the upper body and arms, potentially concentrated on the left side
  • Jaw pain
  • Indigestions or choking feeling
  • Nausea
  • Dizziness or lightheadedness
  • Cold sweat
  • Rapid or irregular heartbeat
  • Unusual fatigue

Any of the following might put you at risk for CTO:

  • Smoking or daily exposure to secondhand smoke
  • Past heart attack or known coronary artery disease
  • Family history of heart disease
  • High cholesterol
  • Taking birth control pills and smoking
  • Being overweight
  • Diabetes
  • Hypertension (high blood pressure)
  • A sedentary or inactive lifestyle

How We Treat

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To diagnose a CTO, a routine physical exam with a careful medical history will be performed. Missouri Heart Center will personalize a treatment plan for every patient with CTO based on the severity of symptoms.

Specialized tests can be used to diagnose CTO. These tests include:

  • Coronary Angiogram
  • Chest X-Ray
  • EKG
  • CT Scan
  • Magnetic Resonance Imaging (MRI)

Possible treatments for CTO

  • Percutaneous intervention
  • Coronary artery bypass surgery (use link to coronary artery bypass graft)