ASE issues Echocardiography guidance amid COVID-19 Pandemic
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The American Society of Echocardiography (ASE) has issued a statement on protecting patients and echocardiography service providers during the COVID-19 pandemic.

Given the risk for cardiovascular complications associated with COVID-19, echocardiographic services will likely be needed for patients with suspected or confirmed COVID-19, meaning echo providers will be exposed to SARS-CoV-2.

Who, When, Where, and How

The statement covers triaging and decision pathways for handling requests for echocardiography, as well as indications and recommended procedures, in cases of suspected or confirmed COVID-19.


-- Only perform transthoracic echocardiograms (TTE), stress echocardiograms, and transesophageal echocardiograms (TEE) if they are expected to provide clinical benefit. Appropriate-use criteria represent the first decision point as to whether an echocardiographic test should be performed.

-- Determine which studies are "elective" and reschedule them, performing all others. Identify "nonelective" (urgent/emergent) indications and defer all others.

-- Determine the clinical benefit of echocardiography for symptomatic patients whose SARS-CoV-2 status is unknown.

-- Cautiously consider the benefit of a TEE examination weighed against the risk for exposure of healthcare personnel to aerosolization in a patient with suspected or confirmed COVID-19.

-- Postpone or cancel TEEs if an alternative imaging modality can provide the necessary information.

-- Note that treadmill or bicycle stress echo tests in patients with COVID-19 may lead to exposure because of deep breathing and/or coughing during exercise. These tests should generally be deferred or converted to a pharmacologic stress echo.

The ASE statement also provides advice on safe imaging protocol and adequate personal protection measures.

"In addition to limiting the number of echocardiography practitioners involved in scanning, consideration should be given to limiting the exposure of staff who may be particularly susceptible to severe complications of COVID-19," the ASE advises.

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