Cardiology's Vision

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Medicine is a wonderful blend of science and art. The physicians we respect most are observant, efficient and caring in their diagnosis. They are able to look into our eyes, listen to our hearts, palpate a region of pain, hear our symptoms and look into their crystal ball to figure out the next and best step.

This month we're taking a look inside the crystal ball of cardiology and looking ahead to 2010. Among the focus in five years will be CT and MR angiography's migration into the cath lab (and a first look at 256-slice CT scanners), as well as PET-CT and SPECT-CT helping to diagnose medium and high-risk patients. Overall, cardiology will be a disease path.

Twenty-first century, personalized medicine also will rely on genetic tests that will tell which lifestyle changes are crucial to us, the asymptomatic individual, and which drugs will be most effective, with the least side effects. That's amazing, personalizing drug regimens (pharmacogenomics) and nutritional advice based on genetic profiling (nutritional genomics). Yes, we'll be waiting more than five years, but technology is in the works. We're already seeing the benefits of personalized medicine for enhanced screening for individuals at risk for disease by looking for the presence or absence of specific genes, as well as testing for the biochemical markers that indirectly reflect genetic makeup and medical history. Blood lipids is just one example - with cholesterol-lowering drugs prescribed prophylacticly.

These new technologies are yielding more information, but is more better? Only as long as the information is smarter, safer - and digestible and actionable for caregivers. That is the domain of the evolving longitudinal cardiology patient record. Of course, cardiologists will be seeing more patients (with more age-related, at-risk patients and fewer cardiologists), with more tests and more images for a longer period of time. The information's reach must be ubiquitous. Strong, flexible information and image management solutions will have deeper archives and larger bandwidths to push and pull multiple, interactive videofiles - and be accessed from a centralized, mobile workstation. That will be the true power of cardiology.