Venn diagrams in cardiovascular disease: the Heart Team concept

Abstract

Venn diagrams are illustrations composed of overlapping circles that demonstrate the relations between finite collections of things1 and are most useful in defining areas of commonality among different aggregations. Originally described by John Venn in the 1880s to teach elementary set theory, these diagrams are most often used to illustrate set relationships in such fields as probability, statistics and computer science. Venn diagrams can also be useful for understanding the roles of various stakeholders in the management of cardiovascular disease from its diagnosis through its treatment. As the field progresses, the area of overlap of the cardiovascular disease Venn diagram continues to expand. This is evident in many aspects of cardiovascular disease management, including individual diagnosticians and treatment specialists, diseases, technologies, institutions, payers and regulators. Despite a movement towards convergence in areas of disease management, however, professional societies remain in their individual silos. This article explores whether Venn diagrams of professional societies, which traditionally had little overlap or mutual engagement, should continue to converge until they merge into one. The well-recognized concept of atherosclerosis as a disease that affects all vascular beds has focused therapeutic strategies on the coexistence, for example, of coronary artery disease and peripheral arterial disease in the same patient. Whereas in the past there was a tendency to treat an acute coronary syndrome as an isolated event in a patient, attention now focuses on the fact that other manifestations of the disease, such as peripheral arterial disease and cerebral vascular disease, are likely to be present in this patient as well, and the involvement of these other vascular beds may affect treatment strategies. Thus, the evolution of the understanding about atherosclerosis has stimulated physicians and surgeons who focus on these different vascular beds to strategize together about the treatment of this patient. Another example of …