Where to image?

The portability of echocardiography affords a clear advantage in imaging patients without having to move them and risk virus transmission in the clinic or hospital. All forms of echocardiography (including chemical stress tests) can be performed in emergency departments, hospital wards, intensive care units, operating theaters, recovery areas and structural heart and electrophysiology procedure laboratories, in addition to echocardiography laboratories. Identifying the optimal location for an echocardiographic study requires minimizing the risk of virus transmission but also considering monitoring capabilities and staffing of different locations. For example, patients with suspected or confirmed COVID-19 are placed in isolation rooms, and echocardiography performed in the patient’s room can prevent transit to other areas of the hospital, risking wider exposure. However, it may not be possible to perform a TEE or stress echo in the room due to staffing or insufficient monitoring equipment.

In the outpatient setting, patients should be screened for infection according to local protocols and methods for quarantine. Some institutions have set aside a separate room and separate machine for patients with suspected or confirmed infection.