搜索结果：European heart journal. Acute cardiovascular care

Background/Objectives: Acute cor pulmonale is a critical clinical condition often encountered in acute care settings. Optimal management demands coordinated, interdisciplinary care. The aim of this study was to assess the current knowledge and management strategies for acute cor pulmonale among different groups of physicians involved in acute care in Switzerland. Methods: A structured questionnaire, extrapolated from the Acute Cardiovascular Care Association of the European Society of Cardiology clinical consensus statement on the diagnosis and treatment of cor pulmonale, was distributed among physicians of four specialties. Results: A total of 110 physicians participated in this multicenter survey, including 15 "experts," 71 "generalists" (internal and emergency medicine), and 24 "specialists" (cardiology and intensive care). Experts validated 29 out of 40 questionnaire items (Fleiss Kappa 0.63), which were then used for analysis. Overall, there was substantial agreement with the experts' answers among non-experts, with most correct response rates exceeding 60%. Significant differences were observed for only two items: experts more frequently recognized the prognostic value of clinical models (87% vs. 59%, p = 0.046) and the correct indications for systemic thrombolysis (100% vs. 76%, p = 0.037). Between generalists and specialists, differences in knowledge were minimal. Specialists more accurately identified the role of repeated arterial blood gas analysis, while generalists showed better awareness of clinical prognostic models. Conclusions: The study highlights a sound knowledge of acute cor pulmonale among acute care physicians, regardless of specialty. Despite comparable levels of knowledge, some variations reflect their clinical roles and information sources. The results emphasize the value of existing educational efforts and support the need for comprehensive, accessible guidelines to standardize care in complex conditions like acute cor pulmonale.

Acute ischaemic stroke patients with atrial fibrillation (AF) are at high risk of suffering a recurrent stroke or other cardiovascular complications. It is uncertain whether early rhythm-control therapy is effective and safe in preventing recurrent strokes and cardiovascular complications in these patients. Early treatment of Atrial fibrillation for Stroke prevention Trial in acute STROKE (EAST-STROKE) is an international investigator-initiated, prospective, randomised, open, blinded endpoint assessment (PROBE) interventional multi-centre trial. Patients with acute ischaemic stroke and AF will be randomised within 4 weeks of stroke (1:1) to receive either early rhythm control and usual care or usual care alone. Usual care includes oral anticoagulation, rate control and treatment of cardiovascular conditions. Early rhythm control additionally comprises treatment with antiarrhythmic drugs, AF ablation or cardioversion. A minimum of 1746 participants will be randomised to observe 351 events. The adaptive design includes one interim analysis with sample size re-estimation after 50% of events. The primary outcome is a composite of first recurrent ischaemic stroke, haemorrhagic stroke, unclassified stroke, cardiovascular death or hospitalisation due to worsening of heart failure or due to acute coronary syndrome, analysed as time to the first occurrence. Secondary outcomes include individual components of the primary outcome, functional status and patient-reported outcome measures. Safety outcomes comprise all-cause mortality and adverse events. Patients will be followed-up until the end of the trial with a minimum follow-up period of 24 months and an expected mean follow-up period of 42 months. EAST-STROKE will determine whether early rhythm-control therapy in addition to usual care is effective and safe in patients with acute ischaemic stroke and AF. ClinicalTrials.gov Identifier: NCT05293080; EUCT-No.: 2025-521260-35-00.

Cardiac intensive care unit (CICU) survivors face significant morbidity and mortality after hospital discharge. Many develop new or worsening physical, cognitive, or psychological impairments consistent with post-intensive care syndrome (PICS). Our current knowledge regarding the epidemiology of and risk factors for PICS is largely derived from general intensive care unit (ICU) cohorts. CICU care includes distinct exposures and pathophysiologic characteristics, including cardiogenic shock, cardiac arrest, temporary mechanical circulatory support, and complex cardiovascular interventions that may alter the frequency of PICS, response to interventions, and result in unique need profiles. This review summarizes existing evidence describing CICU survivors post-discharge, including PICS. It highlights cardiac-specific vulnerabilities and outlines assessment strategies that may be adapted for post-CICU follow-up. Finally, we examine emerging clinic models and key outcome measures relevant to CICU survivors, including patient-centered, caregiver-centered, and cardiac-specific endpoints. Optimal care for CICU survivors must expand beyond the ICU, with structured recovery pathways, standardized tools, and coordinated research efforts to guide best practices and improve long-term outcomes after cardiac critical illness.

Real-life data is very useful for gaining a better understanding of care in practice and identifying areas for improvement. This study aimed to assess changes in the clinical characteristics, care and outcomes of patients hospitalised with acute heart failure (HF). Two multicentre snapshot surveys were conducted in 2009 and 2021 following the same methodology and enrolled 1658 and 1513 patients, respectively. Clinical characteristics, hospitalisation pathways, in-hospital management and short-term outcomes during a 6-month follow-up were collected. While the age of patients and the proportion in each left ventricular ejection fraction (LVEF) category remained largely unchanged (76 years and 53% with reduced LVEF in the two surveys), there was a rise in the prevalence of most comorbidities. Emergency department was the predominant and increasing route for hospitalisation (64-71%), and admission to critical care units remained frequent and stable (40%). In patients with reduced LVEF, the prescription rate of ACE inhibitors, angiotensin receptor blockers or angiotensin receptor-neprilysin inhibitors (ARNis) decreased from 77.8% to 70.6%, while the use of beta-blockers and mineralocorticoid receptor antagonists increased (67.7-74.2% and 26.6-35.5%, respectively) at discharge. Mortality at 1 and 6 months declined from 8.9% to 7.6% and from 24.7% to 21.3%, respectively. This difference was also significant after matching the two cohorts (HR 0.78 (0.66-0.94)). This improvement in mortality was observed in most patients except in the most elderly and those with preserved LVEF. A comparison of two cross-sectional surveys of acute HF, conducted 12 years apart, reveals an increasing burden of comorbidities, as well as a lack of dedicated admission pathways and a significant shortcoming in the prescription of evidence-based HF drugs on discharge. However, there has been a significant decrease in short-term mortality. NCT01080937 and NCT05232058.

Background: Frailty is highly prevalent among older adults with cardiovascular disease (CVD) and strongly predicts disability and mortality after cardiac events. Although cardiac rehabilitation (CR) improves prognosis, frail older patients often face barriers to participating in in-person programs. eHealth-based, home-delivered CR programs incorporating tele-rehabilitation and remote monitoring may improve accessibility, yet evidence regarding their effectiveness on frailty status remains limited. Methods: We designed a multicenter, randomized, parallel-group trial enrolling people ≥65 years recently hospitalized for acute heart failure (AHF) and/or acute coronary syndrome (ACS). Participants were randomized 1:1 to an eHealth home-based tele-rehabilitation program or the usual care. The primary endpoint is frailty prevalence at follow-up, defined by an Essential Frailty Toolset (EFT) score ≥3, with co-primary outcomes being between-group differences in the mean levels of EFT and Short Physical Performance Battery (SPPB) scores after 3-6 months. Secondary endpoints include mortality and hospitalization, among others. Results: The full protocol and study procedures are reported. Between May 2024 and December 2025, 589 patients were screened at the two Italian centers involved; 442 met eligibility criteria and 209 were enrolled and randomized. Baseline characteristics were largely comparable between groups. The mean age was 77 ± 9 years, 70% were male, and 55% had ACS. Lower-than-expected enrollment was mainly attributable to refusal related to difficulties in using digital devices. Conclusions: This randomized trial will evaluate whether a multidomain, eHealth-based CR intervention can reduce the prevalence or degree of frailty in older people after AHF or ACS. We report the study protocol and baseline characteristics of the enrolled cohort, highlighting the challenge of digital illiteracy in contemporary older populations.

Cardiovascular disease is now a leading cause of premature mortality across Africa and is accelerating faster than the capacity to prevent, detect, and manage chronic illness. Most patients still engage with the health system only when heart failure, stroke, or ischemic disease is advanced, reflecting a legacy architecture designed primarily to confront acute infections. At the same time, multiple African countries have demonstrated that high-impact cardiovascular care can be delivered at scale when services are organized around primary and district facilities, supported by clear protocols, continuous supply of essential medicines, workforce development, and access to remote specialist expertise. Global experience, including major reforms in Brazil and Thailand, shows that population-level gains arise from deliberate health system design. Africa now stands at a turning point. By embedding cardiovascular disease prevention and treatment within national strategies for universal health coverage and by aligning financing and service delivery with the realities of chronic care, the region can prevent millions of avoidable deaths. The opportunity to define a different future for cardiovascular health is within reach and must be acted upon with urgency and coherence.

Systolic dysfunction, diastolic dysfunction, and clinically overt heart failure are frequently encountered after acute ischaemic stroke. We investigated whether these cardiac phenotypes, considered as distinct entities, are associated with readmission and death within two years after stroke in the prospective SICFAIL cohort. Adults with acute ischaemic stroke were consecutively enrolled between 01/2014 and 02/2017. Cardiac function was assessed at baseline, and patients were followed annually by mail or telephone. The primary endpoint was the composite of all-cause readmission or death. Secondary analyses considered individual endpoints and cardiovascular readmissions. Associations were estimated using multivariable Cox proportional hazards models. Of 696 enrolled patients, 644 (92.5%) had interpretable echocardiographic data. During two-year follow-up, 206 of 554 patients (37.1%) with complete outcome information were rehospitalised, and 63 of 577 patients (11.4%) with available vital status data died. After adjustment, systolic dysfunction and clinically overt heart failure were independently associated with the composite endpoint (systolic dysfunction: hazard ratio [HR] 1.97 (95% confidence interval [CI], 1.34-2.91); clinically overt heart failure: HR 1.62, 95% CI 1.02-2.58). Systolic dysfunction also predicted cardiovascular readmissions (HR 2.27, 95% CI 1.22-4.21). Diastolic dysfunction was not associated with adverse outcomes. In this cohort, systolic dysfunction and clinically overt heart failure at the time of ischaemic stroke independently predicted the composite of readmission or death over the subsequent two years, whereas isolated diastolic dysfunction was not prognostically informative. Routine echocardiographic assessment after stroke may therefore help identify patients who would benefit from intensified cardiac follow‑up and secondary prevention.

Seasonal factors, particularly during winter, have been associated with worsened heart failure (HF). However, seasonal differences in clinical characteristics, clinical outcomes and environmental mechanisms remain unclear. We analyzed 2,857 patients hospitalized for HF. Patients were classified into four groups by season of admission: spring (March to May, n=788, 27.6%), summer (June to August, n= 699, 24.5%), fall (September to November, n=645, 22.6%) and winter (December to February, n =725, 25.4%). Baseline characteristics, clinical outcomes and environmental factors corresponding to the admission month-such as temperature, atmospheric pressure, relative humidity, sunshine duration, influenza activity and PM2.5 concentration-were compared among the groups. The winter group was older and more frequently had hypertension, diabetes, chronic kidney disease and thyroid disease. No seasonal differences were observed in sex, body mass index, HF etiology, other comorbidities, B-type natriuretic peptide levels, or left ventricular ejection fraction. Compared with the fall group, the winter group was associated with higher risk of in-hospital cardiac and all-cause mortality, 90-day cardiac and all-cause mortality (odds ratio 2.13, 1.85, 1.69, 2.01, 1.80, respectively, p<0.05). With respect to environmental factors, (1) lower temperature was associated with 90-day cardiac and all-cause mortality; (2) shorter sunshine duration was associated with 90-day all-cause mortality; and (3) higher PM2.5 concentrations were associated with in-hospital cardiac mortality. In contrast, atmospheric pressure, relative humidity, and influenza activity were not associated with clinical outcomes. Winter admission for HF was associated with older age, more comorbidities and higher in-hospital and short-term mortality, which may be partly explained by lower temperatures and shorter sunlight.

Because one in three of all individuals die from atherosclerotic cardiovascular disease (ASCVD), prevention of ASCVD is key to public health worldwide. Lipid clinics provide specialized diagnostic assessment, lifestyle management, and evidence-based lipid-lowering treatment to prevent ASCVD and acute pancreatitis in high-risk individuals. This includes individuals with familial hypercholesterolemia and/or markedly increased lipoprotein(a), statin intolerance, refractory or difficult-to-control low-density lipoprotein (LDL) cholesterol, severe hypertriglyceridaemia, and other rare or complex lipid disorders. Such specialized care not only benefits the individual patients and their families but facilitates dissemination of best practices in lipid disorder management to healthcare professionals in individual nations. Despite this, there is a lack of guidance on standards and metrics needed to establish a well-harmonized national lipid clinic network in most countries capable of offering comprehensive care. This consensus paper from the European Atherosclerosis Society Lipid Clinic Network aims to meet this unmet clinical need. We provide recommendations to enhance education and training on lipid disorders and to harmonize lipid clinics at both national and international levels. Furthermore, we provide guidance on optimal staffing structures and development of registries to improve diagnosis and management of lipid disorders. Finally, we offer recommendations to national and regional policymakers on funding of lipid clinics, with the long-term goal of reducing the overall societal burden and costs of cardiovascular and other lipid-related diseases.

Hospital-based analyses of real-world percutaneous coronary intervention (PCI) practice remain limited. How do PCI strategies in non-ST-elevation acute coronary syndromes (ACSs) compare between 2 university hospitals from European countries with different cardiovascular disease burdens, health care systems, and interventional cardiology infrastructures [University and Emergency Hospital, Bucharest, Romania (RO) and University Hospital, Essen, Germany (GER)]? Retrospective, observational, all-comers. All consecutive high- and very high-risk patients with non-ST-elevation ACS undergoing PCI in 2022 were analyzed regarding clinical profiles and revascularization strategies. A total of 392 patients were included (221 RO, 171 GER). RO patients had a worse cardiovascular risk profile, with higher rates of dyslipidemia, diabetes, prior ACS, and left ventricular ejection fraction (LVEF) &#x2264;40% (all P < 0.05). P2Y12 inhibitor pretreatment was markedly higher in RO (78.3% vs. 1.3%, P < 0.001). Despite younger age in RO (64.3 vs. 71.8 years, P < 0.001), median SYNTAX scores (12 vs. 13), left main disease (10.9% vs. 11.1%), and multivessel disease (64.3% vs. 62.6%) were comparable. Radial access (80.5% RO vs. 73.1% GER), ad hoc culprit PCI (98.6% RO vs. 93.0% GER), and complete anatomical revascularization (residual SYNTAX score &#x2264;8; 83.3% RO vs. 77.2% GER) represented standard practice in both hospitals. Use of adjunctive PCI techniques was higher in GER, with intravascular imaging-guided PCI reported only in the German hospital (29.8% of PCIs). In-hospital major adverse cardiac and cerebrovascular events were comparable (10.4% RO vs. 7.6% GER, P > 0.05) and consistently associated with lower LVEF ( P < 0.001). Compared with the German cohort, the Romanian cohort had a similar coronary artery disease burden but a worse overall cardiovascular risk profile at a younger age. Arterial access, PCI timing, and revascularization completeness were similar, while adjunctive PCI techniques were used more frequently in GER. In-hospital major adverse cardiac and cerebrovascular events rates were comparable and consistently associated with lower LVEF.

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Valvular heart disease remains a leading cause of morbidity and mortality. Current biological and mechanical heart valve prostheses have significant limitations and fail to address the patient's needs. Most of the limitations arise from the use of foreign materials, which can largely be addressed by utilizing autologous pericardial tissue. However, not all patients have usable pericardium due to previous interventions. This study investigates peritoneum as a potential alternative to pericardium and evaluates an optimized treatment method for intraoperative tissue treatment. A previously established cross-linking method was optimized and applied to pericardial and peritoneal tissues. The tissues were characterized with respect to biochemical composition, cross-linking degree, biomechanical properties, and structural organization. Furthermore, the feasibility of valve shaping was assessed, and constructs were subjected to acute hydrodynamic testing. Tissue treated with the optimized cross-linking method showed high cytocompatibility and was successfully applied to peritoneal tissue. Compared to pericardium, peritoneum exhibited a higher elastin content and a looser structural organization, resulting in distinct mechanical behavior. Both tissues could be shaped into valve constructs showing adequate acute hydrodynamic behavior under the applied test conditions. The findings suggest that the peritoneum is a promising candidate material for further investigation as a heart valve scaffold. However, differences in microstructure and mechanical behavior highlight the need for further testing, particularly regarding long-term durability, cyclic loading behavior, and tissue remodeling capacity.

Background: Cancer is common among patients with acute myocardial infarction (AMI) and may influence management and outcomes. The prognostic impact of cancer status (active vs. past) and its anatomical site remains insufficiently defined. We evaluated the association between cancer and short- and long-term outcomes after AMI in a large population cohort. Methods: Using linked administrative databases from Lombardy, Italy, we identified adults with a first AMI hospitalization from 2014 to 2022 (N = 124,403). Patients were categorized by cancer history, cancer status (active vs. past), and cancer site. The primary endpoint was in-hospital mortality; secondary endpoints were 1-year all-cause mortality and 1-year rehospitalization for AMI or acute heart failure (AHF). Multivariable log-binomial, Cox, and Fine&Gray models were applied. Results: Overall, 18,463 (14.8%) had a history of cancer. They were older and had higher comorbidity burden. Cancer history was associated with higher in-hospital mortality (adjusted risk ratio [RR] 1.06, 95% CI 0.99-1.13) and one-year mortality (adjusted hazard ratio [HR] 1.46, 95% CI 1.40-1.52). Active cancer carried the greatest risk (in-hospital RR 1.07, 95% CI 1.00-1.15; 1-year HR 1.60, 95% CI 1.53-1.68), whereas past cancer showed no excess mortality. Site-specific analyses identified lung (one-year HR 2.69, 95% CI 2.15-3.37) and hematological cancers (one-year HR 2.19, 95% CI 1.88-2.56) as highest-risk. Elevated mortality with cancer was consistent in STEMI and NSTEMI. Competing-risk analyses showed a similar risk of rehospitalization among cancer and non-cancer patients. Conclusions: In a real-world, unselected AMI population, cancer worsens short- and long-term survival, especially when active and involving the lungs or the hematopoietic tissues. Incorporating cancer status into AMI risk stratification and strengthening cardio-oncology pathways in acute care are warranted to improve patient outcomes.

We used Delphi methodology to provide guidance on gender equality and equity issues in professional life in intensive care, where information is evolving and no clear standard exists. A 12-member Steering Committee (7 women, 5 men) from 7 countries and 46 international panelists [(23 women, 21 men, 2 preferred not to disclose; median age 52 (33-75) years] from 32 countries (43% low- and middle-income) including intensive care practitioners, scientists, researchers, and trainees voted on 57 statements addressing issues related to gender equality and equity in 10 domains of professional life. Delphi rounds were conducted using online surveys. Consensus (at least 75% of panelists voting for a response option) and stability (consistent responses on iterative rounds) were assessed. Six Delphi rounds were conducted between May and July 2025. A 100% response rate was achieved in each round. Consensus and stability were achieved on 43 (75%) of 57 statements from which 37 professional practice guidance statements were developed. Across domains, greater consensus was achieved on equality [23/27 (85.2%)] versus equity [12/18 (66.7%)] statements. Discordant equity statements primarily pertained to academia and engagement in multiprofessional meetings and the workplace. Using a Delphi method, international experts reached consensus to generate 37 professional practice guidance statements. The consensus statements provide needed guidance for professional engagement and highlight areas for policy development to advance gender equity and equality for healthcare workers in intensive care. The discordant statements highlight areas for future research.

To estimate major clinical event rates for patients with atrial fibrillation (AF) and atherosclerotic disease treated with edoxaban in routine practice, and to evaluate how well such patients were represented in ENGAGE AF-TIMI 48, the seminal randomized trial comparing edoxaban against warfarin for AF. ETNA-AF-Europe is a prospective cohort of AF patients receiving edoxaban in routine care. We compared patients with coronary or peripheral artery disease (CAD/PAD) to: (1) those without CAD/PAD in ETNA-AF-Europe, and (2) CAD/PAD patients in ENGAGE AF-TIMI 48. Of 13,164 patients in ETNA-AF-Europe, 23.3% had CAD/PAD. Compared with those without, patients with CAD/PAD had higher rates of stroke/systemic embolism (0.87%/year vs. 0.59%/year; HR 1.5, 95%-CI 1.14-1.88), acute coronary syndrome (1.24%/year vs. 0.37%/year; HR 3.3, 95%-CI 2.60-4.27), major bleeding (1.06%/year vs. 0.81%/year; HR 1.3, 95%-CI 1.04-1.63), cardiovascular death (1.59%/year vs. 0.85%/year; HR 1.9, 95%-CI 1.54-2.26), and all-cause death (6.02%/year vs. 3.53%/year; HR 1.7, 95%-CI 1.55-1.89). Compared with CAD/PAD patients in ENGAGE-AF TIMI-48, those in ETNA-AF-Europe had fewer cardiovascular comorbidities, less prevalent aspirin use (20.2% vs. 50.3%), and lower rates of stroke/systemic embolism (0.87%/year vs. 1.5%/year), major bleeding (1.04%/year vs. 3.0%/year), and cardiovascular death (1.59%/year vs. 3.7%), but higher non-cardiovascular mortality (4.43%/year vs. 1.6%/year). In routine practice, deaths and bleeding were the most common events in edoxaban-treated patients with AF. This pattern was consistent between those with and without atherosclerosis. ENGAGE-AF TIMI-48 participants with CAD/PAD had substantially higher cardiovascular but lower non-cardiovascular risks than those treated in daily practice.Trial registration number: NCT02944019 (ClinicalTrials.gov Identifier).

Holter-ECG monitoring is a critical component of post-stroke diagnostics, guiding cardiac work-up and secondary stroke prevention. Abnormal ECG findings beyond atrial fibrillation (AF) in stroke patients remain understudied. The prospective multicenter MonDAFIS trial randomized patients with acute ischemic stroke or transient ischemic attack (TIA) without known AF to Holter-ECG recording up to 7 days or usual care. Holter-ECG findings from the first 72&#xa0;h of the intervention arm were analyzed to provide a reference guide in clinical practice. Furthermore, 24-hour and 72-hour Holter-ECG monitoring were compared to analyze the value of prolonged monitoring. 24-hour Holter-ECGs from 1,665 patients (median age 67; 40.4% women) identified supraventricular tachycardia (SVT) in 4.1% and newly-diagnosed AF in 2.2% of patients. Premature ventricular complexes were common (85.8%), ventricular couplets (28.0%) or bigeminy (14.0%) less common. Non-sustained ventricular tachycardia (nsVT) was detected in 1.7% of patients. Extended 72-hour-monitoring in 1,283 patients led to higher detection rates across all abnormalities, doubling nsVT (4.4%) and SVT (8.8%) detection rates. Generally, we observed higher detection rates with older age. Detection rates of supraventricular arrhythmias were higher in women, whereas men exhibited higher rates of ventricular abnormalities. Post-stroke ECG monitoring detects various arrhythmias beyond AF in a substantial proportion of individuals. Longer monitoring and older age are associated with increased detection rates, with notable sex-specific differences.

To evaluate the clinical impact of a&#xa0;dedicated multidisciplinary spontaneous coronary artery dissection (SCAD) care pathway compared with standard acute coronary syndrome management, focusing on safety, treatment patterns, clinical outcomes, and recurrence rates in patients with SCAD. In this retrospective observational cohort study, 117 SCAD patients were included: 63&#xa0;managed within a&#xa0;SCAD-specific care pathway and 54&#xa0;receiving standard care prior to or independent of its implementation. The SCAD pathway included protocolized angiographic diagnosis, conservative management when feasible, individualized medical therapy, screening for fibromuscular dysplasia (FMD) and systemic disorders, and SCAD-specific rehabilitation with structured follow-up. The primary endpoint was major adverse cardiovascular events (MACE) at 1&#x2011;year follow-up. Patients in the SCAD pathway group were more often managed conservatively in the acute setting (76% vs.&#xa0;24%, p&#x202f;<&#x2009;0.001), had significantly lower rates of stent implantation (8% vs.&#xa0;65%, p&#x202f;<&#x2009;0.001), and were less frequently prescribed dual antiplatelet therapy (19% vs.&#xa0;96%, p&#x202f;<&#x2009;0.001). At 12-month follow-up, beta-blocker adherence was higher (76% vs.&#xa0;41%, p&#x202f;<&#x2009;0.001), aspirin use was lower (38% vs.&#xa0;59%, p&#x202f;<&#x2009;0.001), and recurrent SCAD occurred numerically less often but not statistically significantly (3% vs.&#xa0;9%, p&#x202f;=&#x2009;0.231). MACE rates were similar between groups, and no deaths occurred. FMD screening was more common in the pathway group (92% vs.&#xa0;17%, p&#x202f;<&#x2009;0.001), facilitating diagnosis and tailored long-term therapy. Implementation of a&#xa0;standardized SCAD care pathway was associated with a&#xa0;safe conservative approach, more targeted secondary prevention, improved beta-blocker adherence, and a&#xa0;trend toward fewer recurrent SCAD events. These findings support integration of SCAD-specific multidisciplinary care into routine clinical practice to improve diagnostic precision and long-term outcomes.

Cardiac vasculitis represents a heterogeneous group of immune-mediated disorders that can involve the coronary vessels, myocardium, valvular apparatus and pericardial tissues. Despite its rarity, cardiac vasculitis may result in significant clinical sequelae such as acute coronary syndrome, heart failure, cardiac arrhythmias and pericarditis. Diagnosis is challenging because symptoms are often non-specific and overlap with other cardiovascular conditions. Early recognition is therefore crucial to prevent delayed treatment and disease progression. Advances in non-invasive multimodality imaging and collaborative cardio-rheumatology care have transformed recognition and management of this disease spectrum. Emerging techniques such as hybrid positron emission tomography-cardiac MRI and quantitative CT imaging permit in-vivo characterisation of inflammation. As per European Alliance of Associations for Rheumatology recommendations, treatment requires early intensive immunosuppression to induce remission, coupled with comprehensive cardiovascular risk management. Additional research is required to validate imaging-guided management algorithms, refine vasculitis-specific cardiovascular risk and define long-term outcomes across disease subtypes.

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