Adapting the role of handheld echocardiography during the COVID-19 pandemic: A practical guide

Abstract

The COVID-19 pandemic has altered our approach to inpatient echocardiography delivery. There is now a greater focus to address key clinical questions likely to make an immediate impact in management, particularly during the period of widespread infection. Handheld echocardiography (HHE) can be used as a first-line assessment tool, limiting scanning time and exposure to high viral load. This article describes a potential role for HHE during a pandemic. We propose a protocol with a reporting template for a focused core dataset necessary in delivering an acute echocardiography service in the setting of a highly contagious disease, minimising risk to the operator. We cover the scenarios typically encountered in the acute cardiology setting and how an expert trained echocardiography team can identify such pathologies using a limited imaging format and include cardiac presentations encountered in those patients acutely unwell with COVID-19.

The Point-of-Care Ultrasound (POCUS) by the Handheld Ultrasound Devices (HUDs) in the COVID-19 Scenario: a Review of the Literature

“…The severity of the COVID-19 infection is related to the development of a severe pulmonary insufficiency and complications, like superinfections, coagulation disorders (deep vein thrombosis, pulmonary embolism), cardiovascular diseases (myocarditis, pericarditis, atrial fibrillation and/or acute hearth failure, Takotsubo cardiomyopathy, shock), cytokine release syndrome, acute kidney and liver injury, and brain damage [ 25 , 75 ]. The HUDs are promising tools for the diagnosis, prognosis, and monitoring of COVID-19-related disorders, and POCUS is increasingly being used, as recently reported [ 68 , 76 – 84 ]. The heart and the lung are the most investigated sites by US in COVID-9 patients, with particular attention to the left/right systolic function, valvular pathology, inferior vena cava collapsibility, intracavitary effusions, lung B-lines, and subpleural consolidations/lung hepatization (for the lung score) [ 69 , 75 , 81 – 83 , 85 – 89 ].…”