On July 12, 2025, the 49th Workshop of the Korean Society of Echocardiography was held at Kangdong Sacred Heart Hospital. The primary focus of Session 1 was for discussions regarding valuable cases of cardiac infection and inflammation. The infection on an atrial septal defect closure device is a rare complication that has been reported only in a few case studies, and our discussions were made to the broad extend, addressing not only its treatments, but also the timing and appropriateness of atrial septal defect closure, as well as the selection of patients requiring for prevention of infective endocarditis. These indirect experiences of serious complication led by a common routine practice once again accentuated the importance of careful consideration of risks and benefits for every medical practice, even standard ones.

The second case was an exemplary case featuring the challenges of diagnosing infective endocarditis in a patient with a prosthetic valve. It was a precious opportunity to share the insights of eminent professors, including Prof. Jae-gwan Song and Prof. Seung-woo Park, into diagnosis and treatment of this complicated case. The subsequent cases on inflammatory cardiac disease were equally compelling. One case of cardiac sarcoidosis remained undiagnosed despite extensive testing, including repeated biopsies, and was finally confirmed only after heart transplantation. It was striking when Professor Koo-young Cho noted that he suspected sarcoidosis from the very first echocardiographic image—a powerful reminder of the diagnostic value of echocardiography. A challenging case of unexplained heart failure in a patient with lung cancer deeply resonated with clinicians, reflecting the complexity of real-world decision-making. It also highlighted the growing importance of cardio-oncology, a rapidly evolving field that continues to raise both concern and interest. Professor Kyung-soon Hong’s retirement lecture was a powerful and inspiring reflection on the journey of women in Korean medicine, and a tribute to the early days and development of women’s cardiology in Korea.

In Session 2, four clinical cases on valvular heart disease & pulmonary hypertension were discussed. As for the valvular cases, a patient with low-flow, low-gradient aortic stenosis was examined. Stress echocardiography and CT imaging were utilized to assess disease severity. Another case described an elderly patient who developed atrial fibrillation/flutter, leading to rapid worsening of tricuspid regurgitation. These cases, along with typical medical cases, provided valuable insights for clinical practice. The case involving a young patient with a congenital atrial septal defect and accompanying pulmonary hypertension sparked an especially active discussion. The broad perspective in determining the treatment strategy, considering the patient’s long-term outcome such as pregnancy, was notable.

Another notable presentation was a case of stiff left atrial (LA) syndrome following cardiac surgery. It allowed us to once again realize the clinical importance of this disease and offered insights into the diagnostic challenges and treatments.

Every time I attend a workshop hosted by the Korean Society of Echocardiography, I am truly grateful to the fellows and professors who generously share their insights and knowledge on entire medical procedures, from diagnosis to treatments, as well as their personal challenges and reflections. For young physicians, learning about real cases from various institutions, besides the one he/she belongs to, and other experts is an invaluable opportunity. I would like to thank the Korean Society of Echocardiography and its committee for giving us this wonderful opportunity.