The cardiovascular pathologist: A pathologist awaiting better definition

Abstract

Cardiology arose as a separate entity and discipline within clinical medicine as a result of an explosive growth of knowledge and a need for its application. These developments particularly related to the modern epidemic of ischemic heart disease because of concerns for cardiovascular diseases in terms of morbidity and mortality and in association with the beginnings of cardiovascular surgery. Thus, almost 50 years ago the need for well-trained cardiologists was recognized. Why the cardiovascular pathologist is still undefined in terms of training, duties, and legal responsibilities is unclear. Several factors seem important in explaining current circumstances. One is an increasing tendency, paralleling an accelerating technological evolution, to ignore static morphology represented by the cadaver or the surgical pathology specimen in favor of imaging (e.g., echocardiography, angiocardiography, and nuclear imaging), which is often done without appreciating that clinical pathological correlations are still vital. Another is the graying of pathology attributable to the early retirement of some and less emphasis on recruitment (1). Potential trainees are more enthused by the application of sophisticated diagnostic techniques applied to the patient in vivo than by autopsy practice, and thus they go to other disciplines. Senior staff must act here; remember that pathology practice is multifaceted and