In addition to this knowledge, clinical practice guidelines and clinical consensus statements for the diagnosis and management of cardiovascular disease developed by the ESC and EACVI include recommendations on which cardiac imaging modality to select and how to act on relevant findings. Cardiologists are well-equipped to interpret imaging findings and report them to referring physicians, and can advise on the need for additional testing (e.g. genetic testing or myocardial biopsy) or therapies (e.g. revascularisation or cardiac device implantation).
A focus on specialty-based rather than competency-based delivery of cardiac imaging services has been one of the major barriers to the wider adoption of fundamental diagnostic tests in many countries. In a report published this year, the European Society of Cardiovascular Radiology and European Society of Radiology outlined their vision of cardiac radiology in Europe which emphasised the need to increase cardiac imaging expertise and capacity amongst radiologists.3 The report failed to acknowledge the integral role of cardiologists in cardiac imaging.
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The ESC and EACVI disagree with the implied view that radiology alone is critical and always required for cardiac imaging. Together with the ESC Patient Forum, they advocate multidisciplinary working where desired and possible. According to the ESC Patient Forum, patients assign little importance to which speciality (cardiology, radiology, nuclear medicine, critical care) provides the investigations; patients just want to receive the best care possible. Today’s paper states: “Cardiology is both central and integral to cardiac imaging, and while collaboration with cardiac radiologists and nuclear cardiology physicians can be useful and is encouraged, it is not essential as long as the required expertise is covered by the imaging cardiologist, which is often the case.”
Professor Petersen said: “The demand for cardiac imaging is increasing as its role in diagnosing patients and guiding treatment continues to expand. A clearly defined competency framework for cardiac imaging standards can ensure that all medical specialists, including cardiologists, have the necessary expertise.”
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