Meredith del Carmen López Rincón

Monterrey, UMAE 34 IMSS, Mexico
Title : The Role of Echocardiography in Acute and Long Covid cardiovascular affection

Abstract

Along COVID-19 pandemic, we have experienced its overwhelming effects, being capable of a wide spectrum of manifestations ranging from a mild disease to a severe inflammatory cascade with fatal consequences. This has forced the world to search in a rushing manner for the most useful diagnostic tools, appropriate management, and an eventual cure for the disease, always understanding that the course of the disease it is being established in an empirical and observational manner, alongside with more control studies. Patients with cardiovascular risk factors have a more severe presentation of the disease, alongside with a cardiovascular affection up to 20% in COVID-19 cases presenting with a rise in biomarkers such as troponins, B-type natriuretic peptide and D-dimer; the latter has been associated with echocardiographic abnormalities and prognostic value. Echocardiography is a non-invasive available tool, that due to its portability provides real-time information in emergency rooms and intensive care units; however due to the high contagiousness rate of the virus, transthoracic echocardiogram (TTE) is considered an intermediate risk of exposure for healthcare personnel and a transesophageal echocardiogram (TEE) as a high-risk study secondary to aerosol generation. The latter requires a careful evaluation of its performance according to its risk-benefit and only when the obtained information will result in a change of therapeutic course, therefore it is only indicated in patients with a torpid course, hemodynamic deterioration, signs of right or left heart failure, persistent arrythmias, acute coronary syndromes, myocarditis, acute pulmonary embolism, stress cardiomyopathy (Takutsubo) and myocardial damage secondary to septic state. Echocardiographic studies must be performed in a focused and fast manner with complete personal protection equipment thus avoiding prolonged exposure. Due to the pandemic evolution, Long Covid is a more frequent entity, presenting with cardiopulmonary and neurological symptoms, ranging from benign transitory orthostatic tachycardia to myocardial fibrosis observed in cardiac magnetic resonance (CMR) even in athletes, in which patients a close follow up is recommended. Due to CMR high cost and low availability, echocardiography, and its advanced modalities (strain) continues to be a first line tool in the follow up of patients with Covid cardiovascular affection to stablish reversible or permanent damage

Biography

Meredith López has completed a Cardiology fellowship endorsed by Autonomous University of Nuevo Leon (UANL) and an Echocardiography fellowship in a Hospital  of High specialty in  Cardiovascular diseases and Thorax in Monterrey, México, endorsed by Monterrey University (UDEM) at age of 30 years.  She also obtained two master’s degrees, the first in Transesophageal Echocardiography by University Menendez Pelayo in Madrid, Spain and the second in Cardiovascular Imaging by the Catholic University of San Antonio in Murcia, Spain. Currently is the Head of the Echocardiography Department and main professor of the Echocardiography Fellowship at IMSS Cardiology Hospital Number 34.  She has several publications of clinical cases and reviews in Mexican, Latin-American and European journals alongside with various book chapters. She also has actively participated in congress, sessions and summits of Cardiovascular Imaging in México as a professor and panelist.