Cardiovascular Imaging and Interventional Procedures in Patients with Novel Coronavirus Infection

The coronavirus disease 2019 (COVID-19) pandemic is a huge challenge to the health system because of the exponential increase in the number of individuals affected. The rational use of resources and correct and judicious indication for imaging exams and interventional procedures are necessary, prioritizing patient, healthcare personnel, and environmental safety. This review was aimed at guiding health professionals in safely and effectively performing imaging exams and interventional procedures.

Coronavirus; COVID-19; Pandemics; Communicable Diseases, Emergency; Cardiovascular Diseases/prevention and control; Diagnostic Imaging; Medical Examination/methods; Diagnostic Techniques and Procedures

Authorship

Isabela Bispo Santos da Silva Costa

Universidade de São Paulo Instituto do Câncer do Estado de São Paulo, São Paulo, SP - BrasilUniversidade de São Paulo Instituto do Câncer do Estado de São Paulo, São Paulo, SP - BrasilBrasilBrasilUniversidade de São Paulo Instituto do Câncer do Estado de São Paulo, São Paulo, SP - Brasil

https://orcid.org/0000-0003-1418-9361

Carlos Eduardo Rochitte

Universidade de São Paulo Instituto do Coração, São Paulo, SP - BrasilUniversidade de São Paulo Instituto do Coração, São Paulo, SP - BrasilBrasilBrasilUniversidade de São Paulo Instituto do Coração, São Paulo, SP - Brasil

Hospital do Coração, São Paulo, SP - BrasilHospital do Coração, São Paulo, SP - BrasilBrasilBrasilHospital do Coração, São Paulo, SP - Brasil

Hospital Pró-Cardíaco, Rio de Janeiro, RJ - BrasilHospital Pró-Cardíaco, Rio de Janeiro, RJ - BrasilBrasilBrasilHospital Pró-Cardíaco, Rio de Janeiro, RJ - Brasil

https://orcid.org/0000-0003-4505-3344

Carlos M. Campos

Universidade de São Paulo Instituto do Coração - Hemodinâmica e Cardiologia Intervencionista, São Paulo, SP - BrasilUniversidade de São Paulo Instituto do Coração - Hemodinâmica e Cardiologia Intervencionista, São Paulo, SP - BrasilBrasilBrasilUniversidade de São Paulo Instituto do Coração - Hemodinâmica e Cardiologia Intervencionista, São Paulo, SP - Brasil

Hospital Israelita Albert Einstein - Hemodinâmica e Cardiologia Intervencionista, São Paulo, SP - BrasilHospital Israelita Albert Einstein - Hemodinâmica e Cardiologia Intervencionista, São Paulo, SP - BrasilBrasilBrasilHospital Israelita Albert Einstein - Hemodinâmica e Cardiologia Intervencionista, São Paulo, SP - Brasil

Silvio Henrique Barberato

CardioEco -Centro de Diagnóstico Cardiovascular, Curitiba, PR - BrasilCardioEco -Centro de Diagnóstico Cardiovascular, Curitiba, PR - BrasilBrasilBrasilCardioEco -Centro de Diagnóstico Cardiovascular, Curitiba, PR - Brasil

Quanta Diagnóstico – Ecocardiografia, Curitiba, PR - BrasilQuanta Diagnóstico – Ecocardiografia, Curitiba, PR - BrasilBrasilBrasilQuanta Diagnóstico – Ecocardiografia, Curitiba, PR - Brasil

https://orcid.org/0000-0002-0711-7995

Gláucia Maria Moraes de Oliveira

Universidade Federal do Rio de Janeiro – Cardiologia, Rio de Janeiro, RJ - BrasilUniversidade Federal do Rio de Janeiro – Cardiologia, Rio de Janeiro, RJ - BrasilBrasilBrasilUniversidade Federal do Rio de Janeiro – Cardiologia, Rio de Janeiro, RJ - Brasil

https://orcid.org/0000-0002-0737-6188

Marcelo Antônio Cartaxo Queiroga Lopes

Hospital Alberto Urquiza Wanderley - Hemodinâmica e Cardiologia Intervencionista, João Pessoa, PB - BrasilHospital Alberto Urquiza Wanderley - Hemodinâmica e Cardiologia Intervencionista, João Pessoa, PB - BrasilBrasilBrasilHospital Alberto Urquiza Wanderley - Hemodinâmica e Cardiologia Intervencionista, João Pessoa, PB - Brasil

Hospital Metropolitano Dom José Maria Pires, João Pessoa, PB - BrasilHospital Metropolitano Dom José Maria Pires, João Pessoa, PB - BrasilBrasilBrasilHospital Metropolitano Dom José Maria Pires, João Pessoa, PB - Brasil

Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - BrasilSociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - BrasilBrasilBrasilSociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brasil

Cesar Higa Nomura

Alexandre A. Abizaid

Hospital Sírio Libanês, São Paulo, SP - BrasilHospital Sírio Libanês, São Paulo, SP - BrasilBrasilBrasilHospital Sírio Libanês, São Paulo, SP - Brasil

Giovanni Cerri

Roberto Kalil Filho

Ludhmila Abrahão Hajjar

https://orcid.org/0000-0001-5645-2055

Mailing Address: Isabela Bispo Santos da Silva Costa • Universidade de São Paulo Instituto do Câncer do Estado de São Paulo – Av. Dr. Arnaldo, 251. Postal Code 01246-000, São Paulo, SP – Brazil E-mail: Isabela.bispo@hc.fm.usp.br

Author Contributions

Conception and design of the research: Costa IBSS, Rochitte CE, Campos CM, Barberato SH, Oliveira GMM, Lopes MACQ, Abizaid AA, Hajjar LA; Data acquisition: Costa IBSS; Writing of the manuscript: Costa IBSS, Rochitte CE, Campos CM, Barberato SH, Lopes MACQ, Hajjar LA; Critical revision of the manuscript for intellectual content: Costa IBSS, Rochitte CE, Oliveira GMM, Lopes MACQ, Abizaid AA, Cerri G, Kalil Filho R, Hajjar LA.

Potential Conflict of Interest

The authors report no conflict of interest concerning the materials and methods used in this study or the findings specified in this paper.

SCIMAGO INSTITUTIONS RANKINGS

Hospital do Coração, São Paulo, SP - BrasilHospital do Coração, São Paulo, SP - BrasilBrasilBrasilHospital do Coração, São Paulo, SP - Brasil

Hospital Pró-Cardíaco, Rio de Janeiro, RJ - BrasilHospital Pró-Cardíaco, Rio de Janeiro, RJ - BrasilBrasilBrasilHospital Pró-Cardíaco, Rio de Janeiro, RJ - Brasil

Quanta Diagnóstico – Ecocardiografia, Curitiba, PR - BrasilQuanta Diagnóstico – Ecocardiografia, Curitiba, PR - BrasilBrasilBrasilQuanta Diagnóstico – Ecocardiografia, Curitiba, PR - Brasil

Hospital Sírio Libanês, São Paulo, SP - BrasilHospital Sírio Libanês, São Paulo, SP - BrasilBrasilBrasilHospital Sírio Libanês, São Paulo, SP - Brasil

Figures

Figures (7)

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Figure 1
– Chest X-ray (XR) and computed tomography (CT) in COVID-19.

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Figure 2
– Recommendations for performing coronary computed tomography angiography during the COVID-19 pandemic. CCTA, coronary computed tomography angiography; TEE, transesophageal echocardiography; ECV, electrical cardioversion.

Thumbnail

Figure 3
– Recommendations for performing cardiac magnetic resonance imaging (CMRI) during the COVID-19 pandemic.

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Figure 4
– Flowchart for the treatment of non-ST-elevation acute coronary syndromes. NSTE-ACS, non-ST-elevation acute coronary syndrome; ACS, acute coronary syndrome.

Thumbnail

Figure 5
– Flowchart for the treatment of ST-elevation acute myocardial infarction (STEMI). In addition to cardiovascular risk stratification, consider readiness to perform reperfusion, ischemia time, and resources available for patient’s proper care. Because of the need for emergency care, all patients with STEMI should be considered as potentially having COVID-19 and treated according to the proper isolation measures until the infection can be thoroughly investigated. PCI, percutaneous coronary intervention.

Thumbnail

Figure 6
– Steps for putting on the personal protective equipment in cases of suspected or confirmed COVID-19.

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Figure 7
– Steps for removing the personal protective equipment in cases of suspected or confirmed COVID-19.

Figure 1 – Chest X-ray (XR) and computed tomography (CT) in COVID-19.

Figure 2 – Recommendations for performing coronary computed tomography angiography during the COVID-19 pandemic. CCTA, coronary computed tomography angiography; TEE, transesophageal echocardiography; ECV, electrical cardioversion.

Figure 3 – Recommendations for performing cardiac magnetic resonance imaging (CMRI) during the COVID-19 pandemic.

Figure 4 – Flowchart for the treatment of non-ST-elevation acute coronary syndromes. NSTE-ACS, non-ST-elevation acute coronary syndrome; ACS, acute coronary syndrome.

Figure 5 – Flowchart for the treatment of ST-elevation acute myocardial infarction (STEMI). In addition to cardiovascular risk stratification, consider readiness to perform reperfusion, ischemia time, and resources available for patient’s proper care. Because of the need for emergency care, all patients with STEMI should be considered as potentially having COVID-19 and treated according to the proper isolation measures until the infection can be thoroughly investigated. PCI, percutaneous coronary intervention.

Figure 6 – Steps for putting on the personal protective equipment in cases of suspected or confirmed COVID-19.

Figure 7 – Steps for removing the personal protective equipment in cases of suspected or confirmed COVID-19.

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