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On September 14 and 15, 1989, a symposium entitled 'Surgical and nonsurgical management of cardiovascular disease' jointly sponsored by the University of Calgary and Foothills Hospital was held to help mark the one year anniversary of an expansion of percutaneous transluminal coronary angioplasty and cardiac surgery services in Calgary to include an academically oriented program at the Foothills Hospital. This program complements and adds to the clinical program which has been active for many years at Calgary's Holy Cross Hospital. This occasion is an opportunity to review the remarkable progress and development over the past 20 years of cardiovascular medicine at the university and in the city of Calgary.