Cresti Alberto, Barchitta Agata, Barbieri Andrea, Monte Ines Paola, Trocino Giuseppe, Ciampi Quirino, Miceli Sofia, Petrella Licia, Jaric Emilija, Solari Marco, Basso Cristina, Pepi Mauro, Antonini-Canterin Francesco
Department of Cardioneurovascular Diseases, Misericordia Hospital, Italy.
Sub Intensive Care Unit, San Antonio Hospital, Padova, Italy.
J Cardiovasc Echogr. 2020 Oct;30(Suppl 2):S18-S24. doi: 10.4103/jcecho.jcecho_58_20. Epub 2020 Oct 27.
The pandemic caused by the new SARS-CoV-2, named coronavirus disease 2019 (COVID-19) disease, has challenged the health-care systems and raised new diagnostic pathways and safety issues for cardiac imagers. Myocardial injury may complicate COVID-19 infection in more than a quarter of patients and due to the wide a range of possible insults, cardiac imaging plays a crucial diagnostic and prognostic role. There is still little evidence regarding the best-imaging pathway and the echocardiographic findings. Most of the data derive from the single centers experiences and case-reports; therefore, our review reflects the recommendations mainly based on expert opinion. Moreover, knowledge is constantly evolving. The health-care system and physicians are called to reorganize the diagnostic pathways to minimize the possibility of spreading the infection. Thus a rapid, bedside, ultrasound assessment of the heart, chest, and leg veins by point-of-care ultrasound seems to be the first-line tool of the fight against the SARS-CoV-2. A second Level of cardiac imaging is appropriate when the result may guide decision-making or may be life-saving. Dedicated scanners should be used and special pathways should be reserved for these patients. The current knowledge on cardiac imaging COVID-19 patients is reviewed.
由新型严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的大流行,即2019冠状病毒病(COVID-19),给医疗系统带来了挑战,并为心脏成像检查人员带来了新的诊断途径和安全问题。超过四分之一的COVID-19患者可能会出现心肌损伤并发症,由于可能的损伤范围广泛,心脏成像在诊断和预后方面起着至关重要的作用。关于最佳成像途径和超声心动图检查结果的证据仍然很少。大多数数据来自单中心经验和病例报告;因此,我们的综述主要基于专家意见给出建议。此外,知识也在不断发展。医疗系统和医生被要求重新组织诊断途径,以尽量减少感染传播的可能性。因此,通过床旁即时超声对心脏、胸部和腿部静脉进行快速超声评估似乎是对抗SARS-CoV-2的一线工具。当结果可能指导决策或可能挽救生命时,进行二级心脏成像检查是合适的。应使用专用扫描仪,并为这些患者预留特殊途径。本文对目前关于COVID-19患者心脏成像的知识进行了综述。