The Dual Role of Echocardiography in the Diagnosis of Acute Cardiac Complications and Treatment Monitoring for Coronavirus Disease 2019 (COVID-19)

Agathi-Rosa Vrettou; John Parissis; Ignatios Ikonomidis

doi:10.3389/fcvm.2020.00129

The Dual Role of Echocardiography in the Diagnosis of Acute Cardiac Complications and Treatment Monitoring for Coronavirus Disease 2019 (COVID-19)

Front Cardiovasc Med. 2020 Sep 2:7:129. doi: 10.3389/fcvm.2020.00129. eCollection 2020.

Authors

Agathi-Rosa Vrettou¹, John Parissis¹, Ignatios Ikonomidis¹

Affiliation

¹ 2nd Department of Cardiology, COVID-19 Infection Reference Center, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Abstract

The Coronavirus Disease 2019 (COVID-19) pandemic, being caused by an easily and rapidly spreading novel betacoronavirus, has created a state of emergency for people, the scientific community, healthcare systems and states, while the global financial consequences are still unfolding. Cardiovascular complications have been reported for COVID-19-infected patients and are associated with a worse prognosis. ECG and biomarkers may raise suspicion of cardiac involvement. However, transthoracic echocardiography is a fast and reliable bedside method to establish the diagnosis of cardiac complications, including acute coronary syndromes, pericarditis, myocarditis, and pulmonary embolism. Early detection of cardiac dysfunction by speckle tracking echocardiography during off-line analysis may be used to identify a high-risk population for development of heart failure in the acute setting. Precautionary measures are mandatory for operators and equipment to avoid viral dispersion. No specific treatment is yet available for severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2), and a variety of antiviral, immune-modifying, and antioxidant agents are therefore under intense investigation. Echocardiography, including assessment of myocardial deformation, may provide a useful tool to monitor the effects of the various treatment regimens on cardiac function both acutely and in the midterm.

Keywords: Coronavirus disease 2019; SARS-CoV 2; anti-inflammatory treatment; antiviral treatment; coronavirus; global longitudinal strain; transthoracic echo.