Abstract 11244: Illness Perception and the Impact of a Definitive Diagnosis on Women with Ischemia Without Obstructive Coronary Artery Disease: A Qualitative Study

Abstract

Introduction: Women are more likely to have ischemia and no obstructive coronary artery disease (INOCA), and the underlying pathologies of this diagnosis (such as microvascular dysfunction and coronary vasospasm) are often not distinguished. Comprehensive invasive physiology testing at the time of invasive coronary angiography (ICA) allows for improved diagnostic accuracy. However, despite increased recognition of INOCA and expanding access to testing, data lacks on the impact of receiving a mechanism-based, definitive diagnosis (DD) on women. Methods: We are conducting in-depth telephone interviews with women with INOCA who recently underwent ICA. Respondents are asked about understanding of diagnosis, healthcare experiences, and health status prior to and following ICA. The interviews are transcribed and analyzed using the constant comparison method. Results: To date, 17 women were interviewed (median age: 55), 14 of whom underwent physiology testing and 13 of whom received a DD. Through iterative coding, four major themes emerged: (1) Illness perception and communication: A DD equipped women with a better understanding of their symptoms and subsequent functional status and provided tools for communication; (2) Psychological toll: A DD relieved frustration with repeated testing, lack of validation, and fear about prognosis; (3) Identity: A DD served as a turning point for reclaiming their personal and professional identity; (4) Lifestyle changes and outlook: A DD brought relief and hope for the future and motivation for a healthier lifestyle. See quotes in Table. Conclusions: Women with INOCA were eager to share experiences (89% participated). Overall, they described the physical, emotional, interpersonal, and financial toll of seeking a diagnosis for their symptoms. Those who received a DD reported better understanding of disease, healthcare experiences, and well-being. Next steps are to continue interviews until thematic saturation is reached.