172. Hidden Heart Disease: Understanding ANOCA and INOCA – A Patient’s Journey

In this episode, Leslie Davis, PhD, ANP, FAANP, and nurse practitioner Linda Wellman discuss ANOCA/INOCA—angina or ischemia with no obstructive coronary arteries—an underdiagnosed condition affecting millions. Through expert commentary and lived experience, the conversation highlights why "normal" cardiac catheterization results can still miss serious heart disease. Listeners will hear Linda’s journey as a patient with ANOCA, learn about diagnostic challenges, treatment considerations, and the critical role nurse practitioners play in advocacy and care. While this condition affects both men and women, women with symptoms are more likely to be dismissed by health care providers, leading to delays in diagnosis and treatment. This episode calls for greater awareness to reduce delays, improve outcomes, and support patients whose symptoms have too often been dismissed.   Learning Objectives Define and differentiate ANOCA/INOCA from obstructive coronary artery disease, including identifying at least two underlying pathophysiologic mechanisms (e.g., microvascular dysfunction and coronary artery spasm). Recognize clinical red flags by identifying at least three patient presentation features that should prompt consideration of ANOCA/INOCA despite a normal coronary angiogram. Apply evidence-informed management principles by listing at least three diagnostic or treatment strategies (e.g., specialized invasive testing, tailored pharmacologic therapy, cardiac rehabilitation) appropriate for patients with suspected or confirmed ANOCA/INOCA.   Learners may claim 0.75 CE credit for this program through February 29, 2028.   A participation code will be provided at the end of the podcast — make sure to write this code down. Once you have listened to the podcast and have the participation code, register for this activity in the AANP CE Center and then visit your My CE Activities page. Click on the "Next Steps" button of the activity and: Enter the participation code that was provided. Complete the overall program evaluation.   This activity is supported by AANP.