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Review
. 2020 Jun;33(6):676-682.
doi: 10.1016/j.echo.2020.04.004. Epub 2020 Apr 9.

Bedside Focused Cardiac Ultrasound in COVID-19 from the Wuhan Epicenter: The Role of Cardiac Point-of-Care Ultrasound, Limited Transthoracic Echocardiography, and Critical Care Echocardiography

Li Zhang  1 , Bin Wang  1 , Jianhua Zhou  2 , James Kirkpatrick  3 , Mingxing Xie  4 , Amer M Johri  5
Affiliations
Review

Bedside Focused Cardiac Ultrasound in COVID-19 from the Wuhan Epicenter: The Role of Cardiac Point-of-Care Ultrasound, Limited Transthoracic Echocardiography, and Critical Care Echocardiography

Li Zhang et al. J Am Soc Echocardiogr. 2020 Jun.

Abstract

Background: Three cases of the application of focused cardiac ultrasound in patients with coronavirus disease 2019 are presented.

Methods: Cardiac point-of-care ultrasound, limited transthoracic echocardiography, and critical care echocardiography were applied in cases of heart failure, pulmonary embolism, and myocarditis with thrombus respectively.

Results: The impact on patient management and the global context of each presentation are discussed.

Conclusions: Focused cardiac point-of-care ultrasound played an important, front-line role in the bedside management of patients during the COVID-19 pandemic in Wuhan, China.

Keywords: COVID-19 infection; Critical care echocardiography; Focused cardiac ultrasound; Limited transthoracic echocardiography; Point-of-care ultrasound.

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Figures

Figure 1
Figure 1
(A) Parasternal long-axis view of the heart revealing a dilated left ventricle. (B) Apical four-chamber view of the heart revealing a dilated left ventricle with reduced function. Right ventricular function appeared normal. (C) Three-chamber view of the heart suggesting at least moderate aortic regurgitation. (D) Parasternal short-axis view of the heart near the base of the left ventricle confirming severe impairment of systolic function. See Supplemental Video 1, Supplemental Video 2, Supplemental Video 3, Supplemental Video 4.
Figure 2
Figure 2
(A) Apical four-chamber view indicated enlargement of the right ventricle with impaired function. Right atrial enlargement was present. (B) Modified view of the right ventricle confirmed impaired function and detected moderate tricuspid regurgitation. (C) Subcostal view of the inferior vena cava demonstrated a dilated vessel that collapsed <50% suggesting increased right atrial pressure. (D) Continuous-wave Doppler of the tricuspid valve revealed elevated regurgitant velocity consistent with increased PASP. See Supplemental Video 5, Supplemental Video 6, Supplemental Video 7.
Figure 3
Figure 3
(A) Parasternal long-axis view demonstrating wall thickening and moderate impairment of systolic function. There was a basal anterior wall motion abnormality. (B) Partial apical four-chamber/two-chamber view demonstrating extension of wall motion abnormality into the apex with likely aneurysm (best visualized in Supplemental Video 9). (C) Apical four-chamber view demonstrating the presence of a large apical thrombus. (D) Parasternal short-axis view proximal to the apex demonstrating impairment of systolic function. See Supplemental Video 8, Supplemental Video 9, Supplemental Video 10, Supplemental Video 11.
Figure 4
Figure 4
Patients with confirmed COVID-19 were managed in isolated units. Ultrasound equipment was dedicated to the units and consisted of a variety of applications from handheld mobile devices to full-service machines. All scan were conducted by trained individuals in full PPE.
See this image and copyright information in PMC

References

    1. American Society of Echocardiography. https://aseuniversity.org/ase/lessons/47 Available at:
    1. Mitchell C., Rahko P.S., Blauwet L.A., Canaday B., Finstuen J.A., Foster M.C. Guidelines for performing a comprehensive transthoracic echocardiographic examination in adults: recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr. 2019;32:1–64. - PubMed
    1. Kirkpatrick J.N., Grimm R., Johri A.M., Kimura B.J., Kort S., Labovitz A.J. Recommendations for echocardiography laboratories participating in cardiac point of care cardiac ultrasound (POCUS) and critical care echocardiography training: report from the American Society of Echocardiography. J Am Soc Echocardiogr. 2020;33:409–422.e4. - PubMed
    1. Mehta P., McAuley D.F., Brown M., Sanchez E., Tattersall R.S., Manson J.J. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395:1033–1034. - PMC - PubMed
    1. Alvi R.M., Frigault M.J., Fradley M.G., Jain M.D., Mahmood S.S., Awadalla M. Cardiovascular events among adults treated with chimeric antigen receptor T-cells (CAR-T) J Am Coll Cardiol. 2019;74:3099–3108. - PMC - PubMed

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