cl in ic s. co m For hundreds of years, anatomists, physiologists, and physicians studied the cardiovascular system at autopsy. Cardiovascular pathologists were autopsy pathologists. Within only the last 50 years, the advent of cardiopulmonary bypass, cardiovascular surgical techniques, endomyocardial biopsy, and cardiac transplantation has brought cardiovascular specimens to the surgical pathology bench. These specimens range in size from 0.2 cm (endomyocardial biopsy) to the entire heart (explant). Compared to other areas of surgical pathology, cardiovascular pathology is a “new” subspecialty. I can remember opening a surgical pathology specimen container in 1984 and seeing an entire heart for the first time. Unfortunately, many surgical pathologists did not embrace the arrival of cardiovascular specimens. Cardiovascular pathology, for the most part, is not tumor pathology. It requires knowledge of cardiac anatomy, cardiac physiology, cardiology, and cardiac surgical procedures. In fact, in some European countries, it is common for cardiovascular pathologists to be trained in clinical cardiology. The increasing importance of making a diagnosis on cardiovascular specimens from living patients put pressure on surgical pathology divisions to find someone to deal with these specimens. Cardiovascular diagnoses could now impact living patients. Additional pressure came during the 1980s from the widely expanding cardiac transplant programs that insisted on cardiac pathology expertise. In more recent years, cardiovascular pathologists have not only had to deal with cardiovascular tissue itself, but with the results of interventional procedures—we must