The scope of heart disease and expanse of cardiovascular research make it difficult for the healthcare team to stay current with updated guidelines and evidence based practice. Heart disease is a broad term that includes structural heart failure, conduction disorders, coronary artery disease and valve disease. The focus of this symposium will be care of the most challenging patients from cardiogenic shock therapy to valve and heart disease management. The goal is to increase the knowledge of the healthcare team on these topics to help them manage patients with heart disease in the community setting.