Department of cardiovascular and neurovascular medicine

• Coronary Care Unit of Ragusa;
• Acute myocardial infarction care Center;
• Cardiology Unit of Ragusa and Modica and Neurology Unit of Vittoria;
• Stroke care center;

Cardiovascular and cerebrovascular disease, in its “chronic” and “acute” clinical expressions, which are often interconnected and interdependent, represents the first cause of death and disability in industrialized countries. Moreover, it is an increasingly important issue for public health, because, due to population ageing, the number of patients is constantly increasing.

Both “time-dependent diseases” and “chronic” diseases fall within the area of competence of the Department. As for “Time-dependent diseases”, such as infarction, stroke and acute ischemia, the promptness of the intervention has a direct impact on the prognosis and on the mortality. On the other hand, for “Chronic” diseases, such as heart failure, arrhythmias and vasculopathies, an integrated and appropriately differentiated approach among the Divisions of the Department, also in coordination with the territory, allows to optimize their management and to reduce rehospitalizations.

The pathogenic mechanisms that underlie cardiovascular and cerebrovascular disease are similar and they are supported, in most of the cases, by intravascular thromboses of the different tributary artery regions. For this reason, about 1/3 of the patients who suffer from a vascular disease in a specific region (for example, the “coronary region”), also suffer from vascular diseases in other regions (for example, the cerebral or the peripheral vascular region).

Endovascular treatment is often preferred for vascular, coronary and cerebrovascular diseases, but its efficacy depends on response times. The choice of a surgical or endovascular type of treatment should be shared and discussed by a multidisciplinary team, and it should NOT be defined by the specific expertise of a professional, or by the availability of a procedure in a specific facility.

A shared multidisciplinary approach and a vision of the Department that includes both specialized hospital care and primary care are therefore indispensable, also in order to create integrated clinical and care networks between hospital and territory, which are guided by care pathways that have to be based on guidelines of high methodological quality.