In this week's JACC podcast, Editor-in-Chief Dr. Harlan Krumholz explores how context, precision, and physiology converge to shape modern cardiovascular care. He opens with an editorial on "The Geography Gap," challenging the one-size-fits-all approach to cardiovascular risk models that ignore geographic variation in disease outcomes. Other featured studies in this issue include trials (OCEAN Mitral, PULSE), optimizing outcomes after transcatheter mitral repair, plus uncovering genetic links between placental malperfusion and congenital heart disease, evaluating CT angiography follow-up after left main PCI, and refining emergency triage with high-sensitivity troponin testing. Dr. Krumholz also speaks to editorials in this issue providing insight on the accompanying JACC articles, and a HeartBeat submission, with a reflection on balance and compassion in pediatric cardiology. Finally, he touches on our other JACC journal content, including new findings on blood groups and COVID-19 cardiovascular outcomes, and the first JACC: Basic to Translational Science Editor's page from the new editor-in-chief, Matthias Nahrendorf, MD, PhD, on the evolving landscape of translational science. This week in JACC highlights cardiology's movement toward more localized, integrated, and human-centered precision medicine.