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Updated: Dec 15, 2025

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
Published on: April 18, 2025
Usefulness of echocardiography to detect cardiac involvement in COVID-19 patients
Matteo Cameli1, Maria Concetta Pastore1, Hatem Soliman Aboumarie2
1Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy.
Insights
Echocardiography can identify and monitor heart damage in patients with COVID-19. This imaging technique helps differentiate between primary cardiac issues and myocardial damage caused by SARS-CoV-2 infection.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- The COVID-19 pandemic, caused by SARS-CoV-2, presents a significant global health challenge.
- Beyond pulmonary manifestations, COVID-19 can impact multiple organs, including the heart.
- A notable percentage of COVID-19 patients experience cardiac symptoms and myocardial injury.
Purpose of the Study:
- To review the applications of transthoracic echocardiography in managing COVID-19 patients with myocardial damage.
- To highlight echocardiography's role in distinguishing primary cardiac disease from COVID-19-related myocardial injury.
- To assess echocardiography's utility in monitoring cardiovascular complications associated with COVID-19.
Main Methods:
- Review of existing literature on echocardiography in COVID-19 patients.
- Emphasis on safety protocols and personal protective equipment during echocardiographic examinations.
- Discussion of echocardiography's role in diagnosing and managing specific cardiac complications.
Main Results:
- Echocardiography aids in differentiating primary cardiac conditions from SARS-CoV-2-induced myocardial damage.
- The technique is valuable for assessing acute myocarditis, arrhythmias, and heart failure in COVID-19.
- Echocardiography can evaluate sepsis-induced myocardial impairment and right ventricular failure related to mechanical ventilation.
Conclusions:
- Transthoracic echocardiography is a crucial tool for the diagnostic and therapeutic management of cardiac complications in COVID-19.
- Its application supports personalized patient care by guiding treatment strategies for cardiovascular involvement.
- Ensuring safety protocols allows for the effective use of echocardiography in this patient population.
Abstract:
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.
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