“Professor Meier is nuts!”. This was the main complaint of a 64-year-old patient requesting a consultation. He had been on atorvastatin for two years, prescribed by his primary physician. Because of chest pain he recently underwent coronary angiography performed by Professor Meier. No coronary lesions were found; in fact, since his coronaries were in pristine shape, Professor Meier told the patient that he could stop the statin. “But”, the patient indicated, “my LDL-C (low-density lipoprotein cholesterol) was above 150 mg/dl (3.9 mmol/l) before atorvastatin and now it has been well below 80 mg/dl (2.1 mmol/l). I never missed a dose and have zero side effects. I looked it up and guidelines clearly recommend a statin in cases like me. Also, I have hypertension and as is obvious, am a bit overweight”.
We present the diagnostic pathway and management of an asymptomatic patient with a solitary, potentially high-risk coronary plaque, utilizing modern and advanced non-invasive and invasive pathophysiological, morphological, and functional assessment. By using coronary computed tomography angiography, computer-based solutions were employed enabling non-invasive understanding of the plaque characteristics and the local and global functional micro-environment. Invasive coronary angiography-based, computational, and wire-free hemodynamic lesion assessment as well as intracoronary imaging with optical coherence tomography were further utilized, allowing for personalized management and guiding coronary revascularization.
The implementation of a new NSTEMI specialized clinical care pathway was associated with a reduction of six hours in the median door-to-cardiology time, a reduction of two days in the length of hospital stay, as well as a significant reduction in the number of misdiagnoses.
The case of a woman with tachycardia induced cardiomyopathy due to PJRT detected at the age of 54 years. The patient refused to undergo catheter ablation and was successfully treated with a beta blocker.
HFpEF is rapidly increasing in incidence and prevalence, accounting for approximately 50% of all new cases of heart failure. It has a significant impact on patients’ quality of life and is associated with a high risk of hospitalization and death. The diagnosis of HFpEF is challenging, and many patients with HFpEF are likely to be unrecognized or misdiagnosed. So far, HFpEF management relies on patient education and treatment of comorbidities. However, the use of SGLT-2 inhibitors has recently demonstrated a significant reduction in the composite outcome of heart failure hospitalizations and cardiovascular mortality in HFpEF, and is now considered as the first-line therapy.
Digitalization of the healthcare sector is changing its landscape. Artificial intelligence is bound to have a major impact on care providers and their interactions with their patients. As promising as new technologies may be, there will be side effects. New technologies will place new and higher demands on its users and will require an extremely high level of expertise to check plausibility. Alongside increases in efficiency and effectiveness, the demands on the humans in healthcare will also rise.
What do the special task forces of the Federal Police and heart surgeons have in common? Maybe the public impression of a burst in power. Or the great responsibility both specialties carry and the expertise in their respective field. The more you think about it, the more parallels become visible.