Improving understanding and management of acute heart failure, myocarditis, pericarditis, amyloidosis, mitochondrial cardiomyopathies, hypertrophic cardiomyopathy, and takotsubo syndrome

European Heart Journal-Valvular and Structural Heart Disease. 1 Over the past two decades, the European Society of Cardiology (ESC) Journal Family has grown significantly, establishing itself as a leading scientific and data resource in cardiovascular medicine.At the heart of this portfolio is its flagship publication, the European Heart Journal, complemented by a wide range of titles that span the entire spectrum of cardiovascular medicine.However, a few key areas remain underrepresented.To address these gaps, the ESC is introducing a new addition to the ESC Journal Family: European Heart Journal-Valvular and Structural Heart Disease.This emerging speciality area of cardiology has developed rapidly with the introduction of transarterial valve implementation and numerous studies and trials thereof, providing an attractive opportunity for a specialized journal.In an ESC Guidelines entitled '2025 ESC Guidelines for the management of myocarditis and pericarditis' by Jeanette Schulz-Menger from the HELIOS Hospital Berlin-Buch in Germany, and colleagues.The Guidelines introduce the term 'inflammatory myopericardial syndrome' (IMPS) in the first ESC clinical practice guidelines covering myocarditis and pericarditis. 2The Guidelines also emphasize a personalized, multimodal approach to diagnosis and treatment, stressing the importance of cardiovascular magnetic resonance as a diagnostic cornerstone.Key recommendations include individualized treatment plans using non-steroidal anti-inflammatory drugs and colchicine for pericarditis, with immunosuppressive therapies reserved for autoimmune cases.The Guidelines advocate for a multidisciplinary team approach and provide structure and clarity to improve diagnosis and outcomes, including tailored exercise and return-to-work guidance.More than 64 million people worldwide have heart failure (HF), and these numbers are expected to rise.Acute HF (AHF) is the leading cause of hospitalization in patients over 65 years old and is linked to high mortality and readmission rates. [3][4]4][5][6][7][8][9] In a Special Article entitled 'Acute heart failure in non-cardiac surgery: a clinical consensus statement of the Association for Acute CardioVascular Care (ACVC) and the Heart Failure Association (HFA) of the ESC', Danielle Gualandro from the University of Basel in Switzerland, and colleagues summarize the available evidence regarding the pathophysiology, prevention, diagnosis, treatment, and prognosis of AHF after non-cardiac surgery. 10AHF may also be a frequent complication in patients hospitalized for other medical reasons as well as after cardiac or non-cardiac surgery.These three entities are summarized as secondary AHF.As secondary AHF has been largely overlooked by medical research and education, little is known about its pathophysiology, phenotypes, diagnosis, management, and prognosis.Secondary AHF occurring after non-cardiac surgery warrants particular attention due to its very high mortality rates of up to 44% within 1 year and is therefore the focus of this review.Key to prevention is understanding and addressing the pathophysiology of AHF after non-cardiac surgery, which involves close monitoring of fluid status to avoid volume overload and/or hypovolaemia, avoiding hypo-and/or hypertension, treating pain and anaemia to prevent tachycardia, and avoiding electrolyte disturbances to prevent arrhythmias.