The ESC Congress 2025 congress was an important meeting for clinical practice guidance in cardiology, with several major societies releasing long-awaited updates. As always, clinical practice guidelines remain central to cardiology, ensuring that the latest trial data and real-world evidence are rapidly translated into consistent, evidence-based patient care. This year’s congress saw the unveiling of important new documents across prevention, acute care and long-term management, equipping cardiologists with refined decision pathways, updated risk-stratification tools and clearer benchmarks to optimise patient outcomes.
The following provides an overview of the guidelines presented at ESC 2025, together with other key guideline updates released earlier in the year.
The 2025 ESC/EACTS guideline strengthens the central role of multidisciplinary Heart Teams and specialized Heart Valve Centres. It tightens imaging criteria (for example, in aortic stenosis and multivalve disease) and refines indications and timing across surgical and transcatheter approaches, aiming to reduce undertreatment and standardize access. Access the full guideline here
This focused update on the 2019 version introduces a fresh risk assessment framework and revised LDL-C goal pathways designed to help teams more consistently reach lipid targets in routine clinical practice. Access the full guideline here
The guideline presents, for the first time, a unified approach to myocarditis and pericarditis. It offers stepwise diagnostic and management algorithms, and introduces the umbrella designation “inflammatory myopericardial syndrome” to account for overlap when a more specific label is not yet determinable. Access the full guideline here
Replacing the 2018 guidance, this update includes revised risk scoring, defined roles for the Pregnancy Heart Team, expanded chapters on disease-specific cardiovascular conditions in pregnancy, and new content on the long-term cardiovascular consequences of adverse pregnancy outcomes. Access the full guideline here
This guideline, published in February 2025, replaces the prior separate STEMI and NSTE-ACS guidelines, integrating updated evidence on antithrombotic strategies and invasive pathways across unstable angina, NSTEMI, and STEMI, including from initial presentation through in-hospital management. To explore the implications of these changes in practice, we spoke with Professor Rao following the ACC 2025 meeting. Access the full guideline here
In this revision of the 2017 the guideline adopts the PREVENT risk equations in place of the Pooled Cohort Equations to guide treatment intensity. Key elements include emphasis on earlier, lifespan-oriented prevention; structured home blood pressure monitoring; clearer thresholds to initiate pharmacotherapy after 3–6 months of lifestyle change in lower-risk adults; and inclusion of renal denervation as an option for selected patients with resistant hypertension. Access the full guideline here.
These 2025 updates highlight a move toward more integrated, evidence-based cardiovascular care. They emphasise collaboration, refined risk assessment, and patient-centred decision-making, with future guidelines likely to advance further towards personalised approaches
Editor: Sven Awege, Education Editor
Disclosures: This article was created by the touchCARDIO team utilizing AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat.) The content was developed and edited by human editors. No funding was received in the publication of this article.
Cite: Key guideline updates in 2025 so far. touchCARDIO. 9 October 2025.
This content has been developed independently by Touch Medical Media for touchCARDIO. It is not affiliated with the European Society of Cardiology (ESC). Views expressed are the speaker’s own and do not necessarily reflect the views of Touch Medical Media.
SIGN UP to touchCARDIO!
Join our global community today for access to thousands of peer-reviewed articles, expert insights, and learn-on-the-go education across 150+ specialties, plus concise email updates and newsletters so you never miss out.
