The past 20 years have seen significant changes in both the demographics and natural history of many cardiovascular diseases. Important reductions in case-fatality rates (such as in acute coronary syndromes) have resulted from improved diagnostics and treatment options and better understanding of natural history. For others (such as infective endocarditis), improvements have been limited and disappointing. While advances in therapy and the scientific evidence underpinning treatments have been crucial, the importance of accurate diagnosis has remained a key element for progress. Many of the principles needed for diagnosis are constant: the pre-eminence of a focused, accurate history, complete physical examination, and timely and relevant investigation endures. It is essential to have a secure knowledge of the strengths and limitations of interpretation of a frequently bewildering array of tests. Progress in this field has been rapid; advances in ultrasound, scintigraphy, and cardiac magnetic resonance stand out at the interface between structure and function central to good patient care.
Natural history of denervation in SMA: Relation to age,SMN2 copy number, and function
