Purpose: : We discussed what is needed for ‘Shared decision making (SDM)’ in the digital medical environment. Methods: : We looked at what needs to be considered for remote SDM by examining research data on communication and remote SDM operation in existing digital environments. Results: : The integration of digital technology in medicine has significantly enhanced remote communication between patients and doctors. Notably, both the quantity and quality of information exchanged among participants have markedly improved. Additionally, as patients can obtain information without relying on hospitals and doctors, the flow of information is changing from one-way (from doctor to patient) to mutual exchange between patients and doctors. SDM is a decision-making process that emphasizes patient participation, exchange of medical information and information about patient preferences, and decisions based on sufficient deliberation and consensus, and is premised on multiple meetings. To ensure effective SDM, it is necessary to understand the synchronous and asynchronous communication methods of digital technology and the exchange of expanded information. Conclusion : To facilitate successful remote Shared Decision Making (SDM), it is crucial for both patients and doctors to have digital literacy, health literacy, and maintain an attitude of respectful communication.

Coronary artery spasm is an uncommon, but well recognized, etiology for acute myocardial infarction. However, cardiogenic shock with myocardial infarction resulting from simultaneous multiple coronary artery spasm has been rarely reported, and not in Korea. Recently, we experienced such a case in a 50-year-old Korean man without previous diagnosis of variant angina. The patient, hospitalized for blood sugar control, developed severe chest pain accompanying ST-segment elevation in multiple leads. The patient immediately received cardiac catheterization because of cardiogenic shock. Coronary angiogram revealed the severe and simultaneous spasm of three major epicardial arteries, which was promptly relieved by an intracoronary administration of isosorbide dinitrate. This case highlights the need to rule out the potential mechanism of coronary spasm even in the most severe episodes of acute coronary syndrome.
Acute Coronary Syndrome ; Arteries ; Blood Glucose ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Coronary Vasospasm ; Coronary Vessels ; Humans ; Isosorbide Dinitrate ; Korea ; Middle Aged ; Myocardial Infarction ; Myocardial Ischemia ; Shock, Cardiogenic ; Spasm

Aorto-right ventricular fistula is a very rare complication of aortic dissection. We report a case of acute aortic dissection extending into the right ventricle as documented by echocardiography. The patient survived after successful surgical repair.
Aorta ; Echocardiography ; Fistula ; Heart Ventricles ; Humans