Episode 15: Conversations from the Heart: Living with Angina
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Maria George
Patient living with coronary artery spasm, microvascular dysfunction, and angina
Chandrima Ghosh
Patient diagnosed with spastic angina and cardiac rhythm complications
In this episode of the Global Heart Podcast, host Pablo Perez speaks with the lead authors of the World Heart Report 2025—Prof. Mariachiara Di Cesare and Prof. Francisco Lopez-Jimenez—about one of the most pressing yet neglected cardiovascular risk factors: obesity. Drawing on extensive research and clinical experience, they examine how obesity contributes to cardiovascular disease (CVD), what makes this report different, and the urgent action needed across clinical and public health systems worldwide.
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Key Takeaways:
The Invisible Face of Angina:
Angina symptoms are often misunderstood—especially in women and younger patients. Far from the classic “chest-clutching” stereotype, symptoms can include jaw, back, arm, or neck pain, fatigue, and sudden weakness. These non-typical presentations frequently lead to misdiagnosis or dismissal.
A Long Road to Diagnosis:
Both patients experienced significant delays—ranging from months to years—before being correctly diagnosed. Inadequate understanding among clinicians, lack of appropriate testing for non-obstructive coronary conditions, and repeated emergency visits with no resolution were common.
Living with Non-Obstructive Coronary Artery Disease:
Conditions like coronary artery spasm and microvascular angina are under-recognized forms of heart disease. Despite normal angiograms, these patients suffer from recurring and debilitating chest pain, fatigue, and fainting episodes. Correct diagnosis often requires persistence, research, and specialist referral.
Beyond Medication—Managing Triggers and Loss:
There is no “cure” for this type of angina—only ongoing management. Patients must adapt their lives around triggers like stress, cold, or even emotional excitement. Many report a profound impact on their independence, social life, and mental health, describing the experience as “grieving the life you expected to have.”
Mental Health and Support Matter:
Anxiety, PTSD, and social isolation are common consequences of living with chronic angina. Patients emphasized the importance of peer support groups and online communities for both emotional resilience and practical advice—validating the lived experience of what is often an invisible disease.
Call to Action:
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Clinical: Improve awareness and training on non-obstructive coronary artery disease among GPs, emergency staff, and cardiologists.
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Public Health: Promote gender-sensitive and symptom-diverse education around heart disease to reduce underdiagnosis in women and younger individuals.
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Policy: Integrate non-obstructive angina into cardiovascular guidelines, ensuring access to specialized diagnostics, treatment, and tailored rehabilitation programs.
Stay informed
Learn more about angina and other under-recognized cardiovascular conditions at the World Heart Federation.
Subscribe to the Global Heart Podcast for firsthand stories and expert insights.
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