Provocative comments can entertain and instruct as long as they are used to stimulate a civilized discussion, and it is fun to embrace an opportunity to change one’s mind (and learn). I am therefore delighted to respond to Adrian Ionescu’s comments, although I think he has got it wrong—as I will aim to demonstrate. In the spirit of this debate, please indulge me while I too let off some steam!
I have always disliked the fact that one of the subspecialties within cardiology, which did not exist when I qualified in the 1970s, has come to be known as “cardiac imaging.” Cardiac diagnosis is not about pictures, although some conditions are indeed instantly recognizable. Usually, what we need to know to understand disease is how the heart is functioning, much more than what it looks like. That is true for coronary arteriography as much as for non-invasive imaging. If I am forced to adopt a subspeciality label, then I would much prefer to be considered a clinical pathophysiologist.
Accurate diagnosis is the sine