Society for Cardiovascular Magnetic Resonance (SCMR) guidance for the practice of cardiovascular magnetic resonance during the COVID-19 pandemic

Abstract

The aim of this document is to provide general guidance and specific recommendations on the practice of cardiovascular magnetic resonance (CMR) in the era of the COVID-19 pandemic. There are two major considerations. First, continued urgent and semi-urgent care for the patients who have no known active COVID-19 should be provided in a safe manner for both patients and staff. Second, when necessary, CMR on patients with confirmed or suspected active COVID-19 should focus on the specific clinical question with an emphasis on myocardial function and tissue characterization while optimizing patient and staff safety.

COVID-19 induced type 2 myocardial infarction in a patient with unknown severe coronary artery disease

“…Cardiac magnetic resonance can differentiate between ischemic and non-ischemic etiologies, such as myocarditis, and further demonstrate the extent and severity of the injury and its impact on ventricular function. 7 Best timing for a diagnostic coronary angiogram is fundamental during the COVID-19 pandemic period, and should be based on the patient cardiovascular risk profile, local and cath lab risk of contamination, and availability of PPE. 5,8,9 Percutaneous coronary intervention (PCI) may be considered over coronary artery bypass graft in selected complex anatomy, with full-PCI or even hybrid revascularization coronary artery bypass graft/PCI on the table for heart team consideration, based on patients clinical status and local situation.…”

“…10 It is noteworthy that surgery should be carried out by a minimum number of health care providers, and the staff member is recommended to be the most experienced, and attention to infection mitigation strategies should be drawn, in the operating room and surgery recovery ward, to avoid and reduce risks of contamination to other patients and health workers. 5,7,8,11 Management of complex coronary artery disease presenting with MI during the COVID-19 pandemic is challenging. Correct diagnosis and initial infection management, with PPE and RT-PCR diagnostic tests, followed by adequate hospital protocols for diagnosis and surgical approach, help decide the best timing for invasive diagnostic procedures and definite treatment, with a full recovery from both COVID-19 and multivessel coronary disease.…”

Society for Cardiovascular Magnetic Resonance (SCMR) guidance for re-activation of cardiovascular magnetic resonance practice after peak phase of the COVID-19 pandemic

“…In the recent initial COVID-19 guideline document, the SCMR classified cardiovascular imaging examinations as urgent, semi-urgent, and elective, and advised that most non-urgent exams be delayed [9]. As the first peak phase passes, semi-urgent and elective CMR examinations can begin to be scheduled.…”

“…Cardiovascular complications of COVID-19 are increasingly reported and there will likely be an increasing role for CMR to better characterize these findings. Please refer to the initial SCMR COVID-19 guidelines and online Preparedness Toolkit for a complete description of CMR imaging of COVID-19 patients or patients under investigation for COVID-19, including ventilated patients [9,25].…”

“…The Society for Cardiovascular Magnetic Resonance (SCMR) has recently provided guidance on best practices for cardiovascular magnetic resonance (CMR) utilization during the COVID-19 pandemic [9]. As the first peak is passing in many locations around the world, some local governments and health care systems have been encouraged to slowly and safely transition to pre-COVID-19 health care delivery volumes [10].…”