Cardiovascular imaging in the acute phase of coronavirus disease 2019 (COVID-19)




SARS COV-2, echocardiography, cardiac magnetic resonance, computed tomography, multimodality imaging, COVID-19


The coronavirus disease 2019 (COVID-19) has become the most critical healthcare issue worldwide since the pandemic was announced in March 2020. Although respiratory symptoms remain the critical characteristic feature of COVID-19 (with acute respiratory syndrome as the leading cause of mortality), the disease also affects other organs. In fact, the involvement of the cardiovascular system during COVID-19 may include acute coronary symptoms, acute heart failure and myocarditis, arrhythmias, cardiac tamponade, pulmonary embolism, and right ventricular failure due to a high-pressure mechanical ventilation. It is vital to note that all of the abovementioned disorders require specific, pandemic-adapted imaging algorithms.

This brief review aims to discuss different cardiac imaging modalities to demonstrate their effectiveness in managing patients in the acute phase of COVID-19.


Download data is not yet available.


Nishiga M, Wang DW, Han Y, Lewis DB, Wu JC. COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives. Nat Rev Cardiol. 2020 Sep;17(9):543–58.

Zeng J-H, Liu Y-X, Yuan J, Wang F-X, Wu W-B, Li J-X, et al. First case of COVID-19 complicated with fulminant myocarditis: a case report and insights. Infection. 2020 Oct;48(5):773–7.

Kumar R, Kumar J, Daly C, Edroos SA. Acute pericarditis as a primary presentation of COVID-19. BMJ Case Rep. 2020 Aug 18;13(8):e237617.

Capaccione KM, Leb JS, D’souza B, Utukuri P, Salvatore MM. Acute myocardial infarction secondary to COVID-19 infection: A case report and review of the literature. Clin Imaging. 2021 Apr;72:178–82.

Gomez JMD, Nair G, Nanavaty P, Rao A, Marinescu K, Suboc T. COVID-19-associated takotsubo cardiomyopathy. BMJ Case Rep. 2020 Dec 12;13(12):e236811.

Hua A, O’Gallagher K, Sado D, Byrne J. Life-threatening cardiac tamponade complicating myo-pericarditis in COVID-19. Eur Heart J. 2020 Jun 7;41(22):2130.

García-Cruz E, Manzur-Sandoval D, Baeza-Herrera LA, Díaz-Méndez A, López-Zamora A, González-Ruiz F, et al. Acute right ventricular failure in COVID-19 infection: A case series. J Cardiol Cases. 2021 Jul;24(1):45–8.

Jevnikar M, Sanchez O, Chocron R, Andronikof M, Raphael M, Meyrignac O, et al. Prevalence of pulmonary embolism in patients with COVID 19 at the time of hospital admission. Eur Respir J. 2021 Mar 10;2100116.

Dupont MVM, Drăgean CA, Coche EE. Right ventricle function assessment by MDCT. AJR Am J Roentgenol. 2011 Jan;196(1):77–86.

Pontone G, Scafuri S, Mancini ME, Agalbato C, Guglielmo M, Baggiano A, et al. Role of computed tomography in COVID-19. J Cardiovasc Comput Tomogr. 2021 Feb;15(1):27–36.

Romero J, Husain SA, Kelesidis I, Sanz J, Medina HM, Garcia MJ. Detection of left atrial appendage thrombus by cardiac computed tomography in patients with atrial fibrillation: a meta-analysis. Circ Cardiovasc Imaging. 2013 Mar 1;6(2):185–94.

Skulstad H, Cosyns B, Popescu BA, Galderisi M, Salvo GD, Donal E, et al. COVID-19 pandemic and cardiac imaging: EACVI recommendations on precautions, indications, prioritization, and protection for patients and healthcare personnel. Eur Heart J Cardiovasc Imaging. 2020 Jun 1;21(6):592–8.

Yau O, Gin K, Luong C, Jue J, Abolmaesumi P, Tsang M, et al. Point-of-care ultrasound in the COVID-19 era: A scoping review. Echocardiogr Mt Kisco N. 2021 Feb;38(2):329–42.

Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing G-J, Harjola V-P, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020 Jan 21;41(4):543–603.

Kulkarni S, Down B, Jha S. Point-of-care lung ultrasound in intensive care during the COVID-19 pandemic. Clin Radiol. 2020 Sep;75(9):710.e1-710.e4.

Lomoro P, Verde F, Zerboni F, Simonetti I, Borghi C, Fachinetti C, et al. COVID-19 pneumonia manifestations at the admission on chest ultrasound, radiographs, and CT: single-center study and comprehensive radiologic literature review. Eur J Radiol Open. 2020;7:100231.

Volpicelli G, Gargani L. Sonographic signs and patterns of COVID-19 pneumonia. Ultrasound J. 2020 Apr 21;12(1):22.

Karamitsos TD, Arvanitaki A, Karvounis H, Neubauer S, Ferreira VM. Myocardial Tissue Characterization and Fibrosis by Imaging. JACC Cardiovasc Imaging. 2020 May;13(5):1221–34.

Kotecha T, Knight DS, Razvi Y, Kumar K, Vimalesvaran K, Thornton G, et al. Patterns of myocardial injury in recovered troponin-positive COVID-19 patients assessed by cardiovascular magnetic resonance. Eur Heart J. 2021 May 14;42(19):1866–78.

Sanghvi SK, Schwarzman LS, Nazir NT. Cardiac MRI and Myocardial Injury in COVID-19: Diagnosis, Risk Stratification and Prognosis. Diagn Basel Switz. 2021 Jan 15;11(1):130.






Review Papers

How to Cite

Sacharczuk W, Dankowski R, Marciniak A, Szałek-Goralewska A, Szyszka A. Cardiovascular imaging in the acute phase of coronavirus disease 2019 (COVID-19). JMS [Internet]. 2021 Sep. 28 [cited 2024 Jul. 19];90(3):e532. Available from:
Received 2021-07-06
Accepted 2021-08-18
Published 2021-09-28