The year 2022 will mark the beginning of a new era for hospitals in North Rhine-Westphalia. With the reorganization of hospital planning in NRW to an allocation of treatment assignments via specialized medical service groups with personnel and infrastructural structural quality requirements specific for this purpose instead of via specialized departments and beds, a new form of hospital planning and structuring is implemented. This method is now proposed by the "government commission for a modern and needs-based hospital treatment" implemented by the Minister of Health Lauterbach as a structurization option for the whole of Germany in combination with hospital treatment levels. Therefore, it would be advisable to become acquainted with the possible effects on cardiovascular medicine in a timely manner, in order to anticipate possible alterations in the treatment assignments of one's own hospital as well as other hospitals with repercussions for cooperations with cardiac surgery.
Many areas of medicine are already doing it, but cardiac surgery in Germany is still very reluctant. We are talking about social media. Digital platforms are increasingly becoming useful tools in everyday life, for example when it comes to patient education and continuing medical education. The visibility of your own paper can also be increased many times over in a very short time. In addition to the positive effects, there are also negative effects. To ensure that the benefits outweigh the negative aspects and that every doctor knows what he or she must adhere to, the German Medical Association has defined clear rules. Use it or lose it.
Pulmonary embolism is a frequent cardiovascular disease which in recent years has shown a reduction in the mortality but an increase in the incidence. Due to the optimization of clinical probability scores and the interpretation of the D‑dimer test, unnecessary examinations using computed tomography with respect to the exclusion of an acute pulmonary embolism can be avoided, also in pregnant women. The evaluation of the right ventricle contributes to a risk-adapted treatment. Treatment consists of anticoagulation, alone or in combination with reperfusion treatment, such as systemic thrombolysis and also catheter-assisted or surgical treatment. In addition to acute treatment of pulmonary embolisms, an adequate aftercare is important, particularly for the early detection of long-term sequelae. This review article summarizes the current recommendations of international guidelines for patients with pulmonary embolism, accompanied by clinical case examples and a critical discussion.