Susan Benson, MD, gynecologist at Ascension St. Vincent Women’s Health, shares why women don’t have to suffer through menopause with a personalized treatment plan.
Chronic total occlusion care
See what makes Ascension St. Vincent in Indiana a national leader in advanced surgical care for heart conditions, including chronic total occlusion.
Chronic total occlusion care in Indiana
See what makes Ascension St. Vincent in Indiana a national leader in advanced surgical care for heart conditions, including chronic total occlusion.
Why choose us
When you choose Ascension St. Vincent for your heart care, your doctor is part of a national heart care team of specialists sharing best practices, research and the latest in cardiovascular therapeutics and treatments — bringing the best of heart care to you.
Understand chronic total occlusion (CTO)
Cardiologists at Ascension St. Vincent are part of a national team of doctors, sharing best practices and advanced treatment options for chronic total occlusion (CTO). This heart condition occurs when there is a total blockage in one or more coronary arteries, and prevents blood containing oxygen and nutrients from flowing to your heart. CTO is a common heart disorder that occurs in 20 to 25 percent of patients with coronary artery disease (CAD). The condition is different from a heart attack because the blockage develops over a three month period of time and symptoms can worsen as the blockage increases.
Symptoms of CTO
Common symptoms of heart chronic total occlusion (CTO) include:
- Chest pain, pressure or tightness
- Fatigue
- Nausea
- Rapid or irregular heartbeat
- Pain in the upper body and arm
- Shortness of breath, trouble breathing
CTO risk factors
Common risk factors for CTO include:
- Diabetes
- End-stage kidney disease
- Family history of premature cardiovascular disease
- High blood pressure
- High LDL cholesterol or low HDL cholesterol
- Known coronary artery disease or history of heart attack
- Obesity
- Postmenopausal women
- Tobacco use
How we diagnose chronic total occlusion (CTO)
This procedure uses a combination of large magnets, radio waves, and a computer to make detailed images of organs and structures in your body. Your doctor may order an MRI of the heart to look at the heart valves and major vessels. It can also detect coronary artery disease and how much damage it has caused. It can also assess heart problems that have been present since birth. It can find tumors and other conditions. Your doctor may order this test before other procedures such as angioplasty or stenting of the coronary arteries and heart or vascular surgery.
Your doctor may recommend this test if you have a condition that involves the blood vessels. CT angiography is a type of medical test that combines a CT scan with an injection of a special dye. This is to make pictures of blood vessels and tissues in a part of your body. The dye is injected through an IV (intravenous) line started in your arm or hand. A CT scan is a type of X-ray that uses a computer to make images of your body. The dye injected to do CT angiography is called a contrast material. This is because it highlights the blood vessels and tissues being studied.
It's used to check the heart's function and structures. During the procedure, a transducer (like a microphone) sends out sound waves at a frequency too high to be heard. When the transducer is placed on the chest at certain locations and angles, the sound waves move through the skin and other body tissues to the heart tissues. The waves bounce or "echo" off the heart structures. These sound waves are sent to a computer that can create moving images on the screen of the heart walls and valves.
This test records the electrical activity of the heart, shows abnormal rhythms (arrhythmias), and can sometimes detect heart muscle damage.
This is also called a treadmill test or exercise ECG. This test is done to monitor the heart while you walk on a treadmill or pedal a stationary bike. Your doctor also monitors your breathing and blood pressure. A stress test may be used to detect coronary artery disease, or to determine safe levels of exercise after a heart attack or heart surgery. This test can also be done using special medicines that stress the heart in a similar manner as exercise does. Sometimes a stress test will collect ECG information along with heart ultrasound pictures. This is called an exercise or stress echocardiogram (echo). It's more sensitive and specific than ECG stress testing alone.
Diagnosis of CTO is based on your medical history, a physical exam and diagnostic tests and procedures.
How we treat chronic total occlusion (CTO)
A minimally invasive procedure that opens blocked coronary arteries to restore blood flow to the heart. A catheter is used to thread through a blood vessel to the blockage to navigate the occlusion. A balloon is then inflated to displace the plaque, and a stent is placed to keep the artery open.
Your cardiologist might suggest CABG to treat blocked or narrowed coronary arteries.
CABG is a surgical technique used to restore healthy blood flow to the heart, improve heart function and reduce symptoms. Our experienced cardiac surgeons perform both on-pump CABG and off-pump CABG, but the procedure is chosen based on the severity of the blockage in the coronary arteries.
On-pump CABG treatment is performed using a heart-lung machine to take over heart function during surgery temporarily. Cardiac surgeons will stop the heart and use the machine to circulate and oxygenate blood while performing complex bypass surgery.
Off-pump CABG, also known as "beating heart surgery," is performed without stopping the heart. This method keeps the heart beating while holding specific parts of the heart still, allowing your surgeon to complete a bypass.
Your doctor may prescribe medication that prevents plaque building up, eases the stress on your heart and reduces symptoms. These medications may include: antiplatelets, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and other medications.
Our heart care specialists perform percutaneous coronary intervention (PCI) using minimally invasive techniques to restore blood flow and relieve symptoms of coronary artery disease. This procedure uses a catheter to insert a balloon in your artery to open up blood flow. A stent is then added to keep the artery open.
Clinical trials
Our doctors are committed to being leaders in cardiovascular research, working to help improve how we diagnose and treat heart and vascular diseases. You can talk to your cardiologist if you are interested in participating in clinical trials.
Get a second opinion from a heart specialist
Decisions about your heart care are important. Getting a second opinion not only provides more information about your condition, but it can help you feel more confident in the doctor and the care plan you choose. Consider getting a second opinion if:
- Your diagnosis or prognosis is unclear
- You’ve been told you have a rare or life-threatening condition
- You would like to explore other treatment options
- Your treatment options are costly or risky
- You want to hear an opinion from another specialist
- Your insurance requires a second opinion
How to get care
To make an appointment, a referral should be made by your primary care doctor or another specialist. Once the referral is received and reviewed, you will be contacted to schedule an appointment with a cardiologist.
If you are experiencing a life-threatening emergency, go directly to the ER or call 911.
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The newly expanded Hilbert Pediatric Emergency Department at Peyton Manning Children’s Hospital provides Central Indiana families with greater access to high-quality, specialized emergency care.
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