Daniel Petri Rocha

Structural heart disease (SHD), a broad category encompassing conditions that affect the valves, walls and chambers of the heart, is a major contributor to cardiovascular morbidity and mortality1,2. Although early diagnosis and treatment are associated with improved outcomes, SHD remains underdiagnosed3, largely because echocardiography — the gold-standard diagnostic test — is time-consuming, costly and not uniformly accessible.

Less than a year into Donald J. Trump’s tenure as the 45th president of the United States of America, federal agencies such as the Environmental Protection Agency (EPA) systematically purged references to climate change from their online resources [1]. The move, intended to align the organization’s web presence with the Trump administration’s agenda of undoing environmental protections, removed links to databases containing historical temperature and emissions records [2].