Japan is the world's top longevity country and the number of cardiovascular diseases is increasing remarkably. In elderly people aged 65 and older, deaths due to stroke and cardiovascular disease are almost the same as cancer deaths. Also, an increase in the incidence of cardiovascular disease from 40 to 50 years is also a problem. Therefore, medical expenditure spent on stroke and cardiovascular disease accounts for 20% of the total medical expenses, which is the largest above cancer. Last December, the Japanese Circulation Society and the Japan Stroke Society were the center and have announced "Five Years Plan to Overcome Stroke and Cardiovascular Disease". Among them, it is stated that the medical systems have been improved and it is important to construct a seamless medical delivery system in the acute, recovery and chronic phases. Active discussions are also being conducted in the working group of the Ministry of Health, Labor and Welfare. Recently as the target diseases of the acute phase medical care systems for cardiovascular disease, acute heart failure and acute aortic dissection have become a problem in addition to acute myocardial infarction. It is necessary to consider the hospitals that can accept urgent coronary intervention (PCI) and medical treatments for emergency cardiovascular diseases during 24 hours 365 days and those that can provide urgent surgical treatments distinctly in the points of medical resources. Furthermore, we should also think its placements of these hospitals. It is also important to establish the inter-hospital network systems that enables comprehensive rehabilitation from the acute phase and can transfer to hospitals in the early recovery stage and chronic phase. They should be set according to the current states of the regions. At this symposium, we would like to discuss issues and perspects regarding such medical systems with members.