For generations, the heart's fate has been read through cholesterol panels and blood pressure cuffs — but a quieter organ, tucked beneath the ribs and rarely examined, may hold its own counsel on cardiovascular risk. Researchers at Mass General Brigham have found that certain visible features of the spleen, analyzed through artificial intelligence across tens of thousands of imaging scans, carry measurable associations with coronary artery disease — associations that persist even after accounting for the classical markers medicine has long relied upon. The discovery invites a reckoning with ho