What is Chronic Total Occlusion and How is it Diagnosed?
- | Category: Heart Imaging
Introduction
Chronic total occlusion (CTO) is a severe form of coronary artery disease that can impact heart health and overall well-being. It occurs when a coronary artery is completely blocked for at least three months, restricting blood flow to the heart muscle. Additionally, although once deemed untreatable, advances in diagnostic tools and interventional techniques now offer hope for patients suffering from CTO.
Furthermore, understanding chronic total occlusion, its symptoms, causes, and diagnostic procedures is necessary for timely medical intervention. Additionally, in this guide, let’s explore chronic total occlusion, how it affects heart function, and the advanced methods used to diagnose and treat it effectively.
What is Chronic Total Occlusion?
Complete blockage of a coronary artery caused by the buildup of plaque made of calcium, cholesterol, and other materials is known as chronic total occlusion. This disorder raises the risk of angina (chest pain), heart failure, and even heart attacks by obstructing oxygen-rich blood flow to certain areas of the heart muscle.
Furthermore, the presence of collateral circulation is one of the main features of chronic complete blockage. In order to supply the affected area, the body may eventually create tiny blood vessels around the blocked artery. However, these collateral vessels are often insufficient to meet the heart’s demand, leading to symptoms such as shortness of breath, fatigue, and persistent chest pain.
Who May Get a Chronic Total Occlusion?
Chronic Total Occlusions are a common condition among people having coronary artery disease (CAD). Additionally, it is estimated that around 1 in 3 people who have CTO are also diagnosed with CAD.
Moreover, the risk factors are similar for CAD and CTO. You are likely to develop CTO if you smoke or have other risk factors like:
- BMI (Body Mass Index) of 30 or higher
- Family history of heart disease
- Diabetes
- High Blood Pressure (hypertension)
- History of heart attacks or coronary artery bypass surgery
- Inactive lifestyle
- High cholesterol (hyperlipidemia)
How Common Are Chronic Total Occlusions?
As people age, chronic total occlusion of coronary artery becomes increasingly prevalent. CTOs have an impact on the following:
- Around 37% of those under 65.
- 40% of people between the ages of 65 and 79.
- Approximately 41% of adults over 85.
Additionally, CTOS may be more common than experts think. Furthermore, a person may have a CTO without a formal diagnosis because some chronic total occlusion of coronary artery doesn’t create symptoms.
Causes of Chronic Total Occlusion
Chronic total occlusion typically results from long-standing atherosclerosis, a condition where fatty deposits build up inside the arteries. Moreover, several factors contribute to the development of chronic total occlusion, including:
- High cholesterol levels – Excess cholesterol can accumulate in the arteries, leading to plaque formation and blockage.
- Hypertension (high blood pressure) – Secondly, increased pressure in the arteries can damage their walls, accelerating the buildup of plaque.
- Diabetes – High blood sugar levels can damage blood vessels, increasing the risk of chronic total occlusion.
- Smoking – Tobacco use contributes to arterial inflammation and plaque buildup, heightening the risk of complete occlusion.
- Obesity and sedentary lifestyle – Finally, lack of physical activity and excessive weight gain can lead to poor cardiovascular health, promoting artery blockages.
Symptoms of Chronic Total Occlusion
Coronary total occlusion may include:
- Tightness, pressure, or pain in the chest.
- Lightheadedness.
- Exhaustion.
- Heartbeat irregularities.
- Feeling queasy.
- Heartbeat that is fast or racing.
- Dyspnea or shortness of breath.
- Ache in the upper arm.
How is Chronic Total Occlusion Diagnosed?
A doctor will review your medical history to diagnose Coronary Total Occlusion. Moreover, they may conduct a physical examination or prescribe a medical diagnostic test. Therefore, look for a precise option for effective cardiovascular screening and get diagnosed today.
Cardiologists use several advanced imaging and diagnostic tests to evaluate the extent and severity of the blockage.
1. Electrocardiogram (ECG)
An ECG is often the first test performed when evaluating heart conditions. Additionally, it records the electrical activity of the heart and can detect abnormalities that may suggest ischemia (reduced blood supply) caused by chronic total occlusion.
2. Stress Test
A stress test assesses how well the heart functions during physical exertion. Patients may undergo an exercise stress test on a treadmill or receive medication that simulates exercise effects. Moreover, abnormalities in heart function during the test can indicate the presence of chronic total occlusion of the coronary artery.
3. Echocardiogram
An echocardiogram uses ultrasound waves to create detailed images of the heart. Moreover, this test helps identify regions of the heart that may not be receiving adequate blood supply due to chronic total occlusion.
4. Coronary Angiography
Coronary angiography is the gold standard for diagnosing chronic total occlusion. It involves injecting a contrast dye into the coronary arteries through a catheter, allowing real-time visualization of blood flow using X-ray imaging. Furthermore, this test provides detailed insights into the location and severity of the occlusion.
5. Computed Tomography Angiography (CTA)
CTA is a non-invasive imaging technique that provides high-resolution 3D images of coronary arteries. Furthermore, it is an effective tool for assessing chronic total occlusion and planning treatment strategies.
6. Magnetic Resonance Imaging (MRI)
Cardiac MRI offers detailed images of the heart’s structure and function. It is particularly useful in evaluating the impact of chronic total occlusion on heart muscle viability.
Additionally, do you want to know the difference between a CT scan and an MRI?
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Treatment Options for Chronic Total Occlusion
Once chronic total occlusion is diagnosed, treatment options aim to restore blood flow, relieve symptoms, and improve heart function. Additionally, depending on the severity of the condition, cardiologists may recommend:
1. Medications
- Antiplatelet drugs (e.g., aspirin, clopidogrel) help prevent blood clots.
- Statins reduce cholesterol levels and slow plaque buildup.
- Beta-blockers and calcium channel blockers improve heart function and reduce angina.
2. Percutaneous Coronary Intervention (PCI)
PCI, also known as angioplasty with stenting, is a minimally invasive procedure that uses a catheter to open the blocked artery and restore blood flow. Furthermore, specialized techniques such as the retrograde approach and antegrade dissection re-entry technique are often used for chronic total occlusion of the coronary artery.
3. Coronary Artery Bypass Grafting (CABG)
In cases where PCI is not feasible, coronary artery bypass surgery may be performed. However, this procedure involves rerouting blood flow around the blocked artery using a healthy blood vessel from another part of the body.
4. Lifestyle Changes
Adopting a heart-healthy lifestyle is necessary in managing chronic total occlusion. Furthermore, this includes:
- Maintaining a balanced diet rich in fruits, vegetables, and whole grains.
- Engaging in regular physical activity.
- Quitting smoking and limiting alcohol consumption.
- Managing stress effectively through meditation and relaxation techniques.
Conclusion
To conclude, chronic total occlusion is a serious cardiovascular condition that can lead to major health complications if not checked. Fortunately, advancements in diagnostic techniques and interventional treatments have improved the outlook for patients with chronic total occlusion of coronary artery.
Furthermore, the optimum course of treatment is determined in large part by early diagnosis using imaging tests such as coronary angiography, CTA, and stress tests. However, treated with drugs, minimally invasive PCI, or surgery, prompt care can improve heart health and quality of life in general. Additionally, Ascend Imaging Center is your trusted platform to get diagnostic tests done with state-of-the-art technology and an efficient team. Trust Ascend for a safe and advanced imaging option.
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