Patients with heart disease can present on any elective list, and also as emergencies. The aim of the Symposium is to explore areas of clinical importance for all practising anaesthetists. Over the years the Symposium has greatly benefitted from presentations by expert cardiologists, anaesthetists, and intensivists, who bring a truly multidisciplinary approach to complex problems and make it easier for all of us to better understand the pathophysiology of heart disease and how to manage patients with often complex problems.