Your heart speaks survey programme – a global survey on the lifestyle impact of ANOCA patients

Background Angina with non-obstructive coronary arteries (ANOCA) patients frequently experience delays in diagnosis and ongoing challenges with symptom management. While the clinical features of ANOCA are increasingly recognised, the broader impact on patients’ daily lives remains largely underexplored. Purpose To evaluate the multidimensional lifestyle burden experienced by patients with ANOCA. Methods In partnership with the International Heart Spasms Alliance, an ongoing web-based survey program was launched to collect global patient perspectives. Participants were recruited internationally via social media and cardiology networks. The theme of this survey is lifestyle impact. Results A total of 569 responses were collected (mean age of 58 ± 10.6; 87% female). Most participants were Caucasian (92%), and resided in Europe (44%), North America (36%) or Australia/Oceania (18%). Underlying diagnoses included diseases of the large vessels (32%; i.e. vasospastic angina) small vessels (23%; i.e. coronary microvascular dysfunction), both (32%), or uncertain (13%). Overall, 80% of participants reported that their condition affected three or more areas of their life. The most impacted domains were physical activity, social participation, and sleep/rest. Half of respondents reported that symptoms prevented them from doing activities they enjoy at least once per week, and 80% had stopped hobbies, sports, or regular activities altogether. Work capacity was substantially affected: 34% reduced their working hours, 32% stopped working entirely, and 20% entered early retirement due to their condition. One in ten participants required sick leave at least weekly, while 77% reported attending work despite feeling unwell at least once per month. Psychosocial burden was also high: one-third reported daily anxiety or worry about symptoms, and half felt socially excluded on a weekly basis. Only 40% felt that their healthcare provider understood their condition. Conclusion ANOCA is associated with a substantial and multidimensional lifestyle impairment, affecting physical functioning, employment, social participation, and psychological wellbeing. These findings highlight the urgent need for improved recognition, patient-centred management strategies, and greater clinician awareness of the disability associated with ANOCA.