Dr. Joan Viladomat

Dr. Joan Viladomat is the principal consultant cardiologist at Hospital Nostra Senyora de Meritxell — the co-principality of Andorra's main hospital, located in the capital Andorra la Vella — where he has served for over 22 years. He is widely regarded as the leading authority on cardiovascular medicine within Andorra, a small sovereign state of approximately 77,000 residents nestled in the Pyrenees mountains between France and Spain.

Dr. Viladomat trained at the Universitat Autònoma de Barcelona before undertaking his cardiology residency at the Hospital de la Vall d'Hebron in Barcelona, one of Spain's foremost academic hospitals. He completed a subspecialty fellowship in echocardiography and cardiac imaging at the Hôpital Lariboisière in Paris. His bilingual Catalan-Spanish training and his French-language training give him a uniquely trilingual clinical background suited to serving Andorra's multilingual population and the significant French and Spanish tourist influx.

A distinctive and clinically important aspect of Dr. Viladomat's practice is his expertise in cardiovascular medicine in the context of high altitude. Andorra's ski resorts, which sit at altitudes of 1,700 to over 2,600 metres, attract millions of visitors annually. High altitude is associated with increased cardiovascular workload, changes in blood viscosity, and risks of altitude sickness, exertional arrhythmias, and decompensation in patients with pre-existing cardiac disease. Dr. Viladomat has developed specialist expertise in pre-ski cardiac screening, altitude-related cardiac risk assessment, and the management of cardiac emergencies arising in Andorra's ski resorts.

For invasive cardiac procedures — including coronary angiography and percutaneous coronary intervention — that exceed the capacity of the Meritxell hospital, Dr. Viladomat coordinates closely with the Hospital Clínic and Hospital de la Vall d'Hebron in Barcelona, to which he refers patients requiring catheterisation laboratory procedures, ensuring continuity of care across the Andorra-Spain border.

Dr. Viladomat completed his medical degree at the Universitat Autònoma de Barcelona, Faculty of Medicine, one of Spain's leading medical institutions. He undertook his cardiology specialty residency at the Hospital Universitari Vall d'Hebron in Barcelona, receiving comprehensive training in clinical cardiology, cardiac imaging, acute coronary syndromes, and cardiac electrophysiology. He subsequently completed a fellowship in echocardiography and cardiac imaging at the Hôpital Lariboisière in Paris, developing advanced expertise in transthoracic and transoesophageal echocardiography, stress echocardiography, and cardiac MRI coordination. He holds the Fellow of the European Society of Cardiology (FESC) designation, awarded in recognition of his clinical expertise and scientific contribution to cardiology. He has completed advanced training in high-altitude medicine through the International Society for Mountain Medicine (ISMM) and is registered with the Societat Andorrana de Medicina (SAM) and the Sociedad Española de Cardiología (SEC), maintaining dual registration reflecting Andorra's clinical ties to Spain.

Dr. Viladomat's cardiology practice at Hospital Nostra Senyora de Meritxell encompasses comprehensive non-invasive cardiac assessment and the management of the most prevalent cardiovascular conditions in Andorra's resident and tourist population. His diagnostic capabilities include transthoracic echocardiography (TTE), transoesophageal echocardiography (TOE), exercise stress testing and pharmacological stress testing, Holter monitoring for arrhythmia detection, and ambulatory blood pressure monitoring for hypertension diagnosis and management.

Hypertension management is a core element of his practice, reflecting the high prevalence of hypertension in Andorra's comparatively affluent, sedentary-in-winter population, and the additional transient blood pressure elevation associated with physical exertion at altitude. He manages atrial fibrillation and other arrhythmias, including rate and rhythm control strategies and anticoagulation management. He also provides comprehensive heart failure management including clinical optimisation of medical therapy and coordination with cardiology centres in Barcelona for device therapy evaluation.

His high-altitude cardiology sub-interest encompasses pre-travel cardiac risk stratification for patients with known heart disease planning to visit Andorra's ski resorts, the acute management of cardiovascular events in the mountain rescue context, and collaboration with the Centre de Medicina de Muntanya (Mountain Medicine Centre) for skiing population cardiac safety protocols.

Dr. Viladomat has published over 40 peer-reviewed articles in journals including the European Heart Journal, the International Journal of Cardiology, and the journal High Altitude Medicine and Biology. His research is distinctive in its focus on cardiovascular risk factors and disease patterns in Andorra's ski-tourism population — a clinically and epidemiologically unique cohort characterised by a mixture of long-term alpine residents and short-stay high-altitude tourists. He has also published on high-altitude cardiovascular physiology, examining how brief altitude exposure in ski tourists with subclinical coronary disease or hypertension may precipitate cardiac events, and how better pre-visit screening might reduce adverse outcomes. He collaborates with the Hospital Clínic Barcelona on cross-border cardiovascular epidemiology research, and his work has been recognised at ESC and SEC congresses. He is a co-investigator on the Andorra Cardiovascular Risk Study, a prospective cohort study examining modifiable risk factors in the Andorran resident population.

Dr. Viladomat is well-experienced in treating international patients, given that Andorra's economy is driven by ski tourism and retail tourism attracting millions of visitors from France, Spain, the United Kingdom, and beyond. He conducts consultations in Catalan, Spanish, French, and English, enabling direct communication with the vast majority of international visitors presenting to the Meritxell hospital. Andorra does not participate in the EHIC scheme, but has bilateral healthcare agreements with Spain and France. Visitors with travel insurance can access Dr. Viladomat's cardiology services, and the Meritxell hospital has experience coordinating with European and international travel insurers. For cardiac emergencies, the hospital provides immediate assessment and stabilisation, with onward transfer to Barcelona or Toulouse facilitated as required. For non-emergency consultations, appointments can be scheduled with advance notice for visitors to Andorra.

Dr. Viladomat has received the Societat Andorrana de Medicina (SAM) Medical Excellence Award in recognition of his foundational role in establishing comprehensive cardiology services in Andorra and his research contributions to high-altitude cardiovascular medicine. The Sociedad Española de Cardiología (SEC) presented him with a Special Recognition Award for his work on cardiovascular risk in ski-tourism populations — a novel and practically important field with growing international relevance. He holds the Fellow of the European Society of Cardiology (FESC) designation and has been invited to present at ESC, SEC, and International Society for Mountain Medicine congresses. He serves as the cardiology advisor to the Andorran Olympic Committee, providing cardiac screening for Andorran national athletes.