INOCA: Ischemia and Non-Obstructive Coronary Artery Disease

Summary:
INOCA refers to symptoms of ischemia without obstructive coronary artery disease (CAD) or flow-limiting disease on left heart catheterization. The prevalence is significant, affecting 3-4 million people in the US, with around 70% of anginal hospitalizations showing non-obstructive CAD findings. It predominantly impacts women (50-70%) compared to men (30-50%) and presents primarily as chest pain.

Epidemiology, Clinical Presentation, & Risk Factors:

• Prevalence: 3-4 million in the US; 70% of anginal hospitalizations are INOCA.
• Common Symptoms: Chest pain.
• Gender Distribution: Higher in women (50-70%) compared to men (30-50%).
• Risk Factors: Diabetes Mellitus, Hypertension, Aging, Dyslipidemia, Inflammatory Diseases.

Pathophysiology:
The pathophysiology of INOCA involves either endothelial-independent or endothelial-dependent mechanisms:

• Endothelial Independent: Involves vascular smooth muscle spasms (functional) and increased microvascular resistance (structural).
• Endothelial Dependent: Microvascular inflammation and functional vasodilation at rest contribute to microvascular dysfunction.

Produced by: Dr. Najah Khan, Edited by Dr. Evelyn Song

CardioNerds Infographics

Explore our comprehensive collection of infographics, categorized by cardiovascular topics such as heart failure and transplantation, arrhythmias and electrophysiology, cardio-obstetrics, cardiovascular imaging, congenital heart disease, prevention, coronary artery disease, critical care, hypertension, pericardial disease, pulmonary hypertension, valvular heart disease, vascular disease, women’s cardiovascular health, diversity, inclusion, and more!

Feel free to download and share these visuals in presentations or on social media. Please use the infographics as provided—without altering or cropping out the creators’ credit.

For even more learning, explore the CardioNerds Tweetorial Page, featuring a curated collection of educational tweetorials!