Who should have CTO PCI?

In the presence of a CTO, an area of the heart muscle does not receive enough blood supply. As a result, the patient may experience chest pain (angina), shortness of breath or even a heart attack. These symptoms occur with exertion and sometimes at rest. 

Individuals with CTOs may experience the following symptoms: 

  • Chest pain, pressure or tightness (angina pectoris) 
  • Shortness of breath that usually worsens with activity 
  • Dizziness 
  • Fatigue 
  • Pain in the upper body and arm 
  • Jaw pain 
  • Certain patients may also have depression and a decreased quality of life. 

Importantly, medications are the primary treatment for every patient who has a CTO. Patients should initially be treated with tablets to check if those alone are sufficient to alleviate their symptoms. However, if symptoms do not improve, opening the CTO can be considered to improve the patient’s quality of life. Indeed, the main objective of CTO PCI is symptom control, and this can be noticeable within days or weeks of the procedure. Studies have shown an improvement in quality of life after the procedure, including: 

  • Reduced chest pain (angina) 
  • Reduced shortness of breath 
  • Increase in physical activity 
  • Decrease in feelings of depression 
  • Higher levels of energy