Volume 20 first explores preventive cardiology, a new subspecialty in cardiovascular medicine, discussing how it is possible to modify lifestyle and coronary risk factors well in advance of clinical events. The authors describes an approach to echocardiography of the aortic arch for reliable demonstration of the arch segments while reducing confounding from a patent ductus arteriosus. This compilation goes on to discuss intravascular ultrasound, which complements the conventional angiographic study and allows for the acquirement of high definition images of arteries for the evaluation of atheroma plaques. Additionally, a brief presentation of the X-ray angiography image processing methods is provided. The perioperative use of dexmedetomidine in cardiac surgery, specifically its role in early extubation, delirium management, and reducing morbidity is assessed. Evidence-based treatments for secondary prevention of ischemic heart diseases are described, including the use of antiplatelet agents, beta-blockers, angiotensin-converting enzyme inhibitors, and statins, as well as lifestyle modifications. The authors propose that the assessment of renal function in patients with heart failure is very important because it can reflect their hemodynamic status and provide a better prognostic score. The authors describe some of the common drug-related problems in patients with cardiovascular diseases, as well as their consequences, so as to identify patients who may be at risk and review several interventions designed to limit their occurrence. The closing study discusses how, to further evaluate for an aortic dissection, additional official radiologic studies likely need to be obtained to aid in diagnosis and operative planning.