Post-cod heart scan without symptoms: not a good idea

Cardiac MRI (CMR) after COVID-19 recovery may be able to detect abnormalities of myocarditis – or to rule them out – but should not be used in the absence of symptoms, cardiologists, a group of radiologists, and Others argued.

“We want to emphasize that the prevalence, clinical significance, and long-term effects of CMR on myocardial injury due to morbidity and mortality are unknown,” he said in an open letter signed by some 50 medical professionals from a range of disciplines written.

According to the group’s argument, until there is better evidence, “testing of asymptomatic members of the general public after COVID-19 is not an indication beyond carefully planned and approved research studies.”

Letters were sent to 18 professional societies, including the American College of Cardiology (ACC), the American Heart Association, and the American College of Radiology, to provide clear guidance to prevent people seeking CMR screening for this purpose .

Controversy increased with the German study that late gadolinium enlargement and other abnormalities occurred on CMR, a myocardial injury in a group of people recovering from mild or moderate cases of COVID-19 compared to healthy controls and risk factors. And suggest inflammation. Controls.

Then researchers at Ohio State University published data last week on CMR scans of collegiate athletes after asymptomatic or mild SARS-CoV-2 infection: 15% had signs of myocarditis and 31% had LGE without T2 stimulation, prior Suggestion of myocardial injury.

Neither study could prove that COVID-19 was the cause of the abnormalities or what the long-term consequences would be. But both were used to make decisions about the safety of the game.

The German group was cautious about interpretation. However, Ohio State researchers wrote that CMR could potentially distinguish a high-risk group from athletes who are safe to participate, “because CMR mapping techniques to control myocarditis have a higher negative future. Is the price to say. ” a Bloomberg The story about the Ohio State data declared it a “call for screen college athletes”.

An Ohio State football fan site, Eleven warriors, Which lobbied to get the games on time, took the latest study as good news. Lead author Saurabh Rajpal, MD, told the site, “So if you do an MRI, and the heart does not show myocarditis, we are giving athletes at OSU. [recovering from COVID-19] Go back to practice. We are letting them return to normal intensity of exercise if their MRI was negative. ”

This is a bad idea for the general public, according to the letter, which stated that people are demanding CMR for asymptomatic screening.

“I have my own personal opinion that casual athletics will be included, but may not be the typical athlete,” said Venkatesh Murthy, MD, PhD, first author of the University of Michigan letter in Ann Arbor Today MedPage.

Consensus guidance from the Sports and Exercise Cardiology Council of the ACC after 3 to 6 months of exercise with risk of normalization of ventricular function, absence of biomarker evidence of inflammation, and absence of motivational arrhythmia with risk restrictions. Including echocardiography, stress testing and rhythm monitoring. ”

For athletes, even with asymptomatic infections, it was recommended that “cardiac testing should be considered, if there is concern for cardiac involvement,” the guidance stated.