[2020 ESC guidelines in the shadow of the COVID-19 pandemic]

"Not a guideline but a guidance" is the motto of this document of guidance by the European Society of Cardiology, which is designed as an orientation aid to learning for physicians in the coronavirus disease 2019 (COVID-19) pandemic A total of 62 European cardiologists as authors and 29 further experts as reviewers have contributed to this 119-page document The emphasis of the guidelines is on a cautious strategy in dealing with a pandemic, which is still characterized by many unknown factors It is consciously limited to cardiovascular diseases In the last update from 10 June 2020 many practical instructions for cardiovascular diagnostics and treatment under the conditions of a pandemic are given These recommendations largely depend on the already well-known guidelines of the ESC To recapitulate them might be helpful but much is redundant The sections on the pathophysiology and pathomechanisms by which severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could specifically affect the cardiovascular system, are informative but sometimes in need of supplementation It is counterproductive to recommend that pathohistological and molecular investigations of tissues from affected and deceased patients should be avoided This document of guidance is an ambitious attempt of a learning recommendation that needs some further improvement It needs an early update if it intends to do justice to the ambitions