Coronary artery disease affects 18 million Americans, and about 20% of these individuals have a completely blocked artery, called a chronic total occlusion, or CTO.
For some, the blocked flow of blood to the heart results in chest discomfort, difficulty breathing, and a diminishing ability to enjoy life; yet too many ignore these symptoms and attribute them to anxiety, fatigue, or aging.
You need a heart catheterization or coronary angiogram to diagnose a CTO correctly.
"I should have had it taken care of sooner,” said John Powers, 45-year-old CTO patient and Mason resident. “I thought you either had a heart attack or you didn’t. I didn’t know you could have middle-of-the-road symptoms; but there I was, having angina—and just writing it off.”
Powers had chest, jaw, and neck discomfort that he says felt like anxiety. But over time, as the discomfort increased, he ended up at The Christ Hospital emergency room.
“That's when I first met Dr. Frizzell,” said Powers. “He walked me through the process of having an angiogram and told me I could expect one of three possibilities: a major blockage, a moderate blockage, or none at all.”
The diagnostic test confirmed that Powers had a complex CTO with a 100% blocked artery, and he was in the right place.
“Our Complex Coronary Therapeutics and CTO program offers exceptional care, the best technology, and the greatest expertise in the state of Ohio, with a success rate of about 90% for opening totally blocked arteries,” said Dean Kereiakes, MD, FACC, MSCAI, President of The Christ Hospital Heart & Vascular Institute. “This level of expertise is found at only a handful of centers around the country.”
CTOs are the number one reason patients are referred for open-heart bypass surgery, but a less invasive angioplasty and stent procedure is available at The Christ Hospital.
“Most of our patients were told there was nothing more anyone could do for them, or that their only option was open-heart surgery,” said Shelly Bruns, MSN Ed, RN-BC, Complex Coronary Therapeutics Program Coordinator. “About 80% of our CTO patients come for a second opinion and that second opinion absolutely changes their lives.”
Jarrod Frizzell, MD, MS, FACC, FSCAI, Medical Director of the Complex Coronary Therapeutics and CTO Program, explained that the program offers a significant alternative for CTO patients. “With a minimally invasive catheter procedure, we can successfully unblock the artery and restore blood flow to relieve pain and restore a patient’s quality of life—without open heart surgery.”
Under the leadership of Dr. Frizzell, The Christ Hospital has developed one of the country’s top five CTO programs, second to none in the state. This CTO team will not give up, no matter how challenging a patient’s situation.
By the time Powers came to the hospital seeking treatment, his condition had become quite complex. But after treatment, Powers has more energy and no angina. Since his successful CTO procedure, Powers admits he feels like a new man.
“We take a team approach to patient care,” explained Dr. Frizzell. “This includes discussions with primary care physicians, interventionalists, nurse practitioners—and most importantly—our patients. They deserve to be heard and involved in treatment plans, and they have the final decision about their care.”
"Dr. Frizzell is my all-time favorite doctor," he said. "He is truly a gem, and the Heart & Vascular Institute is a top-notch facility. Everyone is patient, kind, and professional, and restored health wouldn't be possible without them. I am beyond words to explain how grateful I am for their help."
He described how he dances around the house with his wife, rides his bike, and is traveling again. “Everything is so much better,” he related. “If you have symptoms, don’t wait like I did. I wish someone had told me to get checked out sooner. It’s way too easy to ignore something like this because it doesn't happen all at once—it’s subtle.”
But not all chest pain is the result of a large artery blockage.
Some patients have blockages in the smallest heart vessels, called coronary microvascular disease, or CMD. All too often, the symptoms, such as chest pain and shortness of breath, are misdiagnosed as anxiety. These patients are incorrectly prescribed anti-anxiety medications and counseling—and they remain undiagnosed.
“This abnormality in the small vessels of the heart is present in 30%-40% of patients with chest pain, most of whom are women," said Timothy D. Henry, MD, FACC, MSCAI, Medical Director of The Carl and Edyth Lindner Center for Research and Education. “We are the largest center in the US, performing coronary reactivity testing to diagnose CMD, and have the most unique treatments available. For example, we lead a trial of a new technology to treat CMD patients.”
For over 40 years, The Heart & Vascular Institute has introduced nearly every cardiovascular innovation to the region and has developed subspecialized programs for many complex conditions of the heart, earning its well-deserved reputation as “Cincinnati's Heart Hospital.”
“We have one of the few centers in the nation with a full range of solutions for all forms of heart disease,” said Dr. Kereiakes. “There’s no reason for anyone to live with chest pain.”
If you or a family member suffer from chest pain or other CTO symptoms, call The Christ Hospital Heart & Vascular Institute to see what treatment options are right for you. To find out more, please call 513-935-3060, or visit TheChristHospital.com/second-opinion.