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ESC Congress 2025 – Advancing Integrated Cardiovascular Health (Guidelines Updates)

10 September 2025

Madrid, Spain – August 2025 – The European Society of Cardiology (ESC) Congress 2025 in Madrid has once again served as the world’s largest gathering of cardiovascular professionals, driving ground-breaking science and fostering global dialogue on critical health challenges. His Majesty King Felipe VI emphasised that cardiovascular health is a global challenge and that knowledge should "encounter no borders" when it contributes to progress. This year's congress saw the publication of several significant guidelines and consensus statements, all aiming to reduce the burden of cardiovascular disease and improve patient outcomes.

[NEW PODCAST COMING SOON: We’ll be discussing the highlights from ESC in our upcoming podcast on Spotify.]

1. A Cultural Shift for Mental Health and Cardiovascular Disease

A new ESC Clinical Consensus Statement, the first of its kind developed under the auspices of the ESC Clinical Practice Guidelines Committee, calls for a cultural shift in how the adverse combination of mental health conditions and cardiovascular disease (CVD) is addressed. The statement highlights the multidirectional relationship where one condition increases the risk of the other, leading to much poorer long-term health outcomes for patients experiencing both.

Key recommendations include:

• Systematic screening and support for mental health conditions should be normalised within cardiovascular care.
• Patients undergoing treatment for mental health conditions should be regularly assessed for cardiovascular disease risk.
• The establishment of Psycho-Cardio Teams, comprising mental health professionals (psychologists, psychiatrists) alongside cardiovascular specialists, is advised to provide integrated, person-centred care tailored to local needs.
• The guidelines also identify substantial gaps in knowledge regarding optimal strategies for improving population mental health to reduce CVD risk, and effective screening and treatment of mental health conditions in CVD patients. This includes a particular need for evidence-based protocols for individuals with severe mental illness, who face an increased risk of arrhythmias and sudden cardiac death due to various factors including distress, unhealthy lifestyles, and certain medications.

[COMING SOON: PCCS President, Prof Raj Thakkar will be delivering a presentation on this within our Academy – make sure you’re a member so you don’t miss it!]

2. Updated Guidelines for Valvular Heart Disease

The updated ESC/EACTS Guidelines for Valvular Heart Disease aim to prevent the under-treatment of patients and support more equitable, higher-quality care. Recognising an exponential increase in medical knowledge, these guidelines integrate new data from randomised controlled trials, particularly concerning newer, less invasive therapy options.

Significant points include:

• Updated recommendations for the use of less invasive techniques such as transcatheter aortic valve implantation (TAVI) or minimal invasive mitral valve surgery. TAVI, for instance, is described as a minimally invasive procedure to replace a malfunctioning valve, improving blood flow.
• Emphasis on shared and patient-centred decision-making by multidisciplinary expert Heart Teams.
• Recommendation that patients with complex conditions or requiring complex procedures should be referred to high-volume specialist centres.
• Expansion of guidance on sex-specific considerations, assessment of disease causes, and management of multiple/combined valvular heart diseases.
• Acknowledgement of the increasingly important role of advanced imaging techniques (e.g., 3D echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging) in screening and evaluation.

3. New Guidelines for Myocarditis and Pericarditis

For the first time, the ESC has published combined guidelines for myocarditis and pericarditis, aiming to improve diagnosis and treatment and facilitate a quicker return to exercise and work for patients. These conditions are thought to be widely underdiagnosed.

Key innovations:

• Introduction of a new umbrella term: inflammatory myopericardial syndrome (IMPS). This term will increase awareness of the spectrum of the disease, allowing for more timely diagnosis and better management.
• Provision of algorithms and easy-to-use flow charts to help medical professionals better recognise, diagnose, and treat these conditions.
• A paradigm change in diagnosis, increasing awareness of multimodality imaging, with a special role for cardiac magnetic resonance imaging (CMR).
• Specific guidance to help patients return to work and exercise more promptly, often after additional testing like CMR to ensure safety, thereby aiding recovery and supporting mental health.
• Highlighting significant evidence gaps and the need for large-scale prospective multicentre trials, especially for chronic conditions and specific patient groups (children, women of childbearing age, pregnant/breastfeeding women, the elderly).
• Recommendations for managing complicated IMPS cases with a multidisciplinary team including cardiologists, imaging experts, infectious disease experts, surgeons, intensive care specialists, and geneticists. Genetic testing is also recommended for patients with recurrent IMPS.

4. Focused Update on Lipid Levels and Cardiovascular Risk

A new ESC/EAS Focused Update to Guidelines on managing lipid levels introduces a new approach to assessing cardiovascular risk and reaching treatment goals.

Key recommendations:

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