Visual art and representation in cardiology: Past, present, and future

Cardiovascular diseases (CVD) have been the leading causes of morbidity and mortality for over three decades, highlighting the necessity of integrating creative methods with traditional and innovative approaches for patient care, education, and prevention. Historically, artistic representations have played a crucial role in shaping our understanding of the anatomy, physiology, and pathologies of the human heart and cardiovascular system. Creative expressions, including visual arts, are linked to improved overall well-being for individuals of all ages. This review explores the evolution of visual arts in cardiovascular medicine over time, the understanding, diagnosis, and communication of cardiovascular disease and health through major domains of visual arts - education (medical illustrations, interactive anatomic models), symbolism (healing), advocacy (heart disease awareness, cardiac-focused exhibitions, interactive murals or art installations) and innovation (3D modeling, digital art, generative art, advanced medical visualization and imaging). We also reviewed the latest advancements in incorporating visual art into personalized cardiac care, the role of portraits in recognizing underrepresented groups, and future applications of visual representations and concepts through artificial intelligence aimed at enhancing cardiovascular care, medical education, and cardiac research.