Cameli Matteo, Pastore Maria Concetta, Soliman Aboumarie Hatem, Mandoli Giulia Elena, D'Ascenzi Flavio, Cameli Paolo, Bigio Elisa, Franchi Federico, Mondillo Sergio, Valente Serafina
Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy.
Adult Intensive Care Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK.
Echocardiography. 2020 Aug;37(8):1278-1286. doi: 10.1111/echo.14779. Epub 2020 Jul 12.
Coronavirus disease 2019 (COVID-19) outbreak is a current global healthcare burden, leading to the life-threatening severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, evidence showed that, even if the prevalence of COVID-19 damage consists in pulmonary lesions and symptoms, it could also affect other organs, such as heart, liver, and spleen. Particularly, some infected patients refer to the emergency department for cardiovascular symptoms, and around 10% of COVID-19 victims had finally developed heart injury. Therefore, the use of echocardiography, according to the safety local protocols and ensuring the use of personal protective equipment, could be useful firstly to discriminate between primary cardiac disease or COVID-19-related myocardial damage, and then for assessing and monitoring COVID-19 cardiovascular complications: acute myocarditis and arrhythmias, acute heart failure, sepsis-induced myocardial impairment, and right ventricular failure derived from treatment with high-pressure mechanical ventilation. The present review aims to enlighten the applications of transthoracic echocardiography for the diagnostic and therapeutic management of myocardial damage in COVID-19 patients.
2019年冠状病毒病(COVID-19)疫情是当前全球的一项医疗负担,由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引发,可危及生命。然而,有证据表明,尽管COVID-19造成的损害主要表现为肺部病变和症状,但它也可能影响其他器官,如心脏、肝脏和脾脏。特别是,一些感染患者因心血管症状前往急诊科就诊,约10%的COVID-19患者最终出现了心脏损伤。因此,根据当地安全规程并确保使用个人防护设备,超声心动图检查首先有助于区分原发性心脏病或COVID-19相关的心肌损伤,进而用于评估和监测COVID-19的心血管并发症:急性心肌炎和心律失常、急性心力衰竭、脓毒症诱发的心肌损伤以及高压机械通气治疗导致的右心室衰竭。本综述旨在阐明经胸超声心动图在COVID-19患者心肌损伤诊断和治疗管理中的应用。