In 2021, emergency medicine has been impacted by the Covid19 pandemic. The repercussions were both on clinical and scientific aspects specific to our discipline. For this special issue, we have chosen not to insist on the pandemic but to return to some fundamentals of our discipline: cardiovascular emergencies remain the leading cause of death in the world and the aspects of risk stratification of pathologies such as acute coronary syndromes or neurovascular attack remain a daily issue within the framework of the strategies of management and investigation in emergency medicine. In addition, the consideration of alternative treatments in the context of pathologies, ranging from cannabis consumption to cardiac arrest and atrial fibrillation, also remains a daily challenge.