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Review
. 2021 Dec 15;17(5):5-15.
doi: 10.14797/mdcvj.1040. eCollection 2021.

Noninvasive Imaging for Patients with COVID-19 and Acute Chest Pain

Awad Javaid  1 , Yehia Saleh  2 , Ahmed Ibrahim Ahmed  2 , Jean Michel Saad  2 , Maan Malahfji  2 , Mouaz H Al-Mallah  2
Affiliations
Review

Noninvasive Imaging for Patients with COVID-19 and Acute Chest Pain

Awad Javaid et al. Methodist Debakey Cardiovasc J. .

Abstract

Acute chest pain is a common presentation in patients with COVID-19. Although noninvasive cardiac imaging modalities continue to be important cornerstones of management, the pandemic has brought forth difficult and unprecedented challenges in the provision of timely care while ensuring the safety of patients and providers. Clinical practice has adapted to these challenges, with several recommendations and societal guidelines emerging on the appropriate use of imaging modalities. In this review, we summarize the current evidence base on the use of noninvasive cardiac imaging modalities in COVID-19 patients with acute chest pain, with a focus on acute coronary syndromes.

Keywords: COVID-19; acute coronary syndromes; cardiovascular disease; coronavirus; noninvasive imaging.

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Conflict of interest statement

Dr. Al-Mallah receives research support from Siemens, unrelated to this work, and is a consultant for Pfizer and Philips. No other authors had conflicts to disclose.

Figures

Coronary computed tomography (CT) angiography in a 34-year-old woman who presented with COVID-19 pneumonia
Figure 1
Coronary computed tomography (CT) angiography in a 34-year-old woman who presented with COVID-19 pneumonia. The patient had chest pain and minimal troponin elevation. (A) Coronaries were free of atherosclerosis or stenosis. (B) Chest CT shows advanced COVID-19 pneumonia.
(A) Severe pulmonary infiltrates in a patient with recent COVID-19 infection. (B) There is rubidium uptake in these pulmonary infiltrates
Figure 2
(A) Severe pulmonary infiltrates in a patient with recent COVID-19 infection referred for positive emission tomography myocardial perfusion imaging. (B) There is rubidium uptake in these pulmonary infiltrates.
Flowchart for noninvasive imaging in patients with COVID-19 presenting with acute chest pain
Figure 3
Flowchart for noninvasive imaging in patients with COVID-19 presenting with acute chest pain. ACS: acute coronary syndrome; ECG: electrocardiogram; CAD: coronary artery disease; ICA: invasive coronary angiography; POCUS: point-of-care ultrasound; TTE: transthoracic echocardiogram; CCTA: coronary computed tomography angiography; CT: computed tomography; CTPA: computed tomography pulmonary angiography; CMR: cardiac magnetic resonance imaging
See this image and copyright information in PMC

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