Related Experiment Videos
Multimodality Imaging in Evaluation of Cardiovascular Complications in Patients With COVID-19: JACC Scientific Expert
Lawrence Rudski1, James L Januzzi2, Vera H Rigolin3
1Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Insights
Managing cardiovascular complications of coronavirus disease-2019 (COVID-19) is complex. This guidance helps clinicians use advanced imaging for diagnosing and managing heart issues in COVID-19 patients, aiding differential diagnosis and treatment.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- Cardiovascular complications are a significant challenge in coronavirus disease-2019 (COVID-19).
- Differentiating COVID-19 related cardiac issues from other cardiovascular diseases requires advanced diagnostic tools.
- Standard diagnostic methods may not be sufficient for complex cases.
Purpose of the Study:
- To provide guidance on the evaluation and management of cardiovascular complications in COVID-19 patients.
- To outline the role of advanced imaging techniques in diagnosing and managing these conditions.
- To assist clinicians in differential diagnosis and treatment strategies.
Main Methods:
- Review of common clinical scenarios involving COVID-19 and cardiovascular involvement.
- Consideration of biomarker testing to guide imaging decisions.
- Discussion on the application of various advanced imaging modalities.
Main Results:
- Guidance is offered for scenarios including chest discomfort with ECG changes, hemodynamic instability, and left ventricular dysfunction.
- The role of imaging in the subacute/chronic phase of COVID-19 is addressed.
- Differential diagnostic considerations are provided for each scenario.
Conclusions:
- Advanced cardiovascular imaging is crucial for accurate diagnosis and management of COVID-19 related cardiac complications.
- Biomarker testing and clinical presentation should guide the selection of appropriate imaging techniques.
- This guidance aims to improve patient outcomes by optimizing diagnostic and therapeutic pathways.
Abstract:
Standard evaluation and management of the patient with suspected or proven cardiovascular complications of coronavirus disease-2019 (COVID-19), the disease caused by severe acute respiratory syndrome related-coronavirus-2 (SARS-CoV-2), is challenging. Routine history, physical examination, laboratory testing, electrocardiography, and plain x-ray imaging may often suffice for such patients, but given overlap between COVID-19 and typical cardiovascular diagnoses such as heart failure and acute myocardial infarction, need frequently arises for advanced imaging techniques to assist in differential diagnosis and management. This document provides guidance in several common scenarios among patients with confirmed or suspected COVID-19 infection and possible cardiovascular involvement, including chest discomfort with electrocardiographic changes, acute hemodynamic instability, newly recognized left ventricular dysfunction, as well as imaging during the subacute/chronic phase of COVID-19. For each, the authors consider the role of biomarker testing to guide imaging decision-making, provide differential diagnostic considerations, and offer general suggestions regarding application of various advanced imaging techniques.