The coronavirus disease 2019 (COVID-19) pandemic has created new and unpredictable challenges for modern medicine and healthcare systems. Preliminary reports have demonstrated that older age, previous cardiovascular disease, diabetes, and hypertension are risk factors for increased mortality.Data on the cardiac affinity of the virus and its potential to harm the cardiovascular system and the mechanisms by which this occurs are sparse. A systemic infection generally increases demand on the heart, and can exacerbate underlying cardiac conditions. When the lungs are heavily involved, as seen in COVID-19 patients, this may have a major impact on cardiac function, particularly that of the right ventricle. Finally, COVID-19 may have direct effects on the heart, as may some drugs being used in its treatment.
Cardiologists and cardiology departments are heavily affected by this rapidly changing situation.5 The COVID-19 pandemic also increases the burden on cardiac imaging services generally. However, given its wide availability and key role as a bedside test, echocardiography is the most affected cardiac imaging modality. Common challenges faced by all cardiac imaging modalities during the pandemic include limited expert staff availability [sickness or redeployment in prioritized areas, such as intensive care units (ICUs)] and the risk of peri-procedural transmission of SARS-CoV-2 between patients and staff. The scope of these EACVI recommendations is to summarize how these challenges may be addressed during the pandemic. In particular, we focus upon bold prioritization and provide specific indications and recommendations on how to perform an echocardiogram during the pandemic whilst safeguarding both patient and staff.
Skulstad H, Cosyns B, Popescu BA, Galderisi M, Salvo GD, Donal E, Petersen S, Gimelli A, Haugaa KH, Muraru D, Almeida AG, Schulz-Menger J, Dweck MR, Pontone G, Sade LE, Gerber B, Maurovich-Horvat P, Bharucha T, Cameli M, Magne J, Westwood M, Maurer G, Edvardsen T. COVID-19 pandemic and cardiac imaging: EACVI recommendations on precautions, indications, prioritization, and protection for patients and healthcare personnel. Eur Heart J Cardiovasc Imaging 2020 Apr 3. pii: jeaa072. doi: 10.1093/ehjci/jeaa072