Características ecocardiográficas, pertinencia e impacto clínico del ecocardiograma transtorácico de los pacientes con infección sospechosa/confirmada por coronavirus-19 (SARS-CoV2) en el hospital universitario nacional de Colombia
ilustraciones, gráficas, tablas
- Autores:
-
Ruano Cadena, Andrés
- Tipo de recurso:
- Fecha de publicación:
- 2022
- Institución:
- Universidad Nacional de Colombia
- Repositorio:
- Universidad Nacional de Colombia
- Idioma:
- spa
- OAI Identifier:
- oai:repositorio.unal.edu.co:unal/80949
- Palabra clave:
- 610 - Medicina y salud::616 - Enfermedades
Infecciones por Coronavirus
Servicios de Salud
Coronavirus Infections
Health Services
Diagnosis, ultrasonic
Diagnóstico ultrasónico
SARS-CoV2
COVID-19
Ecocardiografía
Impacto clínico
Uso apropiado
SARS-CoV2
COVID-19
Echocardiography
Clinical impact
Appropriate use
- Rights
- openAccess
- License
- Atribución-NoComercial 4.0 Internacional
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Características ecocardiográficas, pertinencia e impacto clínico del ecocardiograma transtorácico de los pacientes con infección sospechosa/confirmada por coronavirus-19 (SARS-CoV2) en el hospital universitario nacional de Colombia |
| dc.title.translated.eng.fl_str_mv |
Echocardiographic characteristics, relevance and clinical impact of the transthoracic echocardiogram of patients with suspected/confirmed coronavirus-19 disease (SARS-CoV2) at the National University Hospital of Colombia |
| title |
Características ecocardiográficas, pertinencia e impacto clínico del ecocardiograma transtorácico de los pacientes con infección sospechosa/confirmada por coronavirus-19 (SARS-CoV2) en el hospital universitario nacional de Colombia |
| spellingShingle |
Características ecocardiográficas, pertinencia e impacto clínico del ecocardiograma transtorácico de los pacientes con infección sospechosa/confirmada por coronavirus-19 (SARS-CoV2) en el hospital universitario nacional de Colombia 610 - Medicina y salud::616 - Enfermedades Infecciones por Coronavirus Servicios de Salud Coronavirus Infections Health Services Diagnosis, ultrasonic Diagnóstico ultrasónico SARS-CoV2 COVID-19 Ecocardiografía Impacto clínico Uso apropiado SARS-CoV2 COVID-19 Echocardiography Clinical impact Appropriate use |
| title_short |
Características ecocardiográficas, pertinencia e impacto clínico del ecocardiograma transtorácico de los pacientes con infección sospechosa/confirmada por coronavirus-19 (SARS-CoV2) en el hospital universitario nacional de Colombia |
| title_full |
Características ecocardiográficas, pertinencia e impacto clínico del ecocardiograma transtorácico de los pacientes con infección sospechosa/confirmada por coronavirus-19 (SARS-CoV2) en el hospital universitario nacional de Colombia |
| title_fullStr |
Características ecocardiográficas, pertinencia e impacto clínico del ecocardiograma transtorácico de los pacientes con infección sospechosa/confirmada por coronavirus-19 (SARS-CoV2) en el hospital universitario nacional de Colombia |
| title_full_unstemmed |
Características ecocardiográficas, pertinencia e impacto clínico del ecocardiograma transtorácico de los pacientes con infección sospechosa/confirmada por coronavirus-19 (SARS-CoV2) en el hospital universitario nacional de Colombia |
| title_sort |
Características ecocardiográficas, pertinencia e impacto clínico del ecocardiograma transtorácico de los pacientes con infección sospechosa/confirmada por coronavirus-19 (SARS-CoV2) en el hospital universitario nacional de Colombia |
| dc.creator.fl_str_mv |
Ruano Cadena, Andrés |
| dc.contributor.advisor.spa.fl_str_mv |
Méndez Toro, Arnold Amaris Peña, Oscar Ernesto |
| dc.contributor.author.spa.fl_str_mv |
Ruano Cadena, Andrés |
| dc.subject.ddc.spa.fl_str_mv |
610 - Medicina y salud::616 - Enfermedades |
| topic |
610 - Medicina y salud::616 - Enfermedades Infecciones por Coronavirus Servicios de Salud Coronavirus Infections Health Services Diagnosis, ultrasonic Diagnóstico ultrasónico SARS-CoV2 COVID-19 Ecocardiografía Impacto clínico Uso apropiado SARS-CoV2 COVID-19 Echocardiography Clinical impact Appropriate use |
| dc.subject.decs.spa.fl_str_mv |
Infecciones por Coronavirus Servicios de Salud |
| dc.subject.decs.eng.fl_str_mv |
Coronavirus Infections Health Services |
| dc.subject.lemb.eng.fl_str_mv |
Diagnosis, ultrasonic |
| dc.subject.lemb.spa.fl_str_mv |
Diagnóstico ultrasónico |
| dc.subject.proposal.spa.fl_str_mv |
SARS-CoV2 COVID-19 Ecocardiografía Impacto clínico Uso apropiado |
| dc.subject.proposal.eng.fl_str_mv |
SARS-CoV2 COVID-19 Echocardiography Clinical impact Appropriate use |
| description |
ilustraciones, gráficas, tablas |
| publishDate |
2022 |
| dc.date.accessioned.none.fl_str_mv |
2022-02-11T16:45:17Z |
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2022-02-11T16:45:17Z |
| dc.date.issued.none.fl_str_mv |
2022-02-10 |
| dc.type.spa.fl_str_mv |
Trabajo de grado - Especialidad Médica |
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info:eu-repo/semantics/masterThesis |
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http://purl.org/redcol/resource_type/TM |
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acceptedVersion |
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https://repositorio.unal.edu.co/handle/unal/80949 |
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Universidad Nacional de Colombia |
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Repositorio Institucional Universidad Nacional de Colombia |
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https://repositorio.unal.edu.co/ |
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https://repositorio.unal.edu.co/handle/unal/80949 https://repositorio.unal.edu.co/ |
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Universidad Nacional de Colombia Repositorio Institucional Universidad Nacional de Colombia |
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spa |
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Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020; 579(7798): 270–3. DOI: https://doi. org/10.1038/s41586-020-2012- 7 World Health Organization. Novel Coronavirus (2019-nCoV) - Situation report - 7 - 27 January 2020. https://www.who.int/docs/default- source/coronaviruse/situation-reports/20200127-sitrep-7-2019--ncov. pdf?sfvrsn=98ef79f5_2020. 2020. Saavedra C, et al. Consenso colombiano de atención, diagnóstico y manejo de la infección por sars-cov-2/covid-19 en establecimientos de atención en salud. Infectio. Marzo 2020;24(3) Prabhakaran D, Perel P, Roy A, Singh K, Raspail L, Faria-Neto JR, Gidding SS, Ojji D, Hakim F, Newby LK, Stępińska J, Lam CSP, Jobe M, Kraus S, Chuquiure-Valenzuela E, Piñeiro D, Khaw KT, Bahiru E, Banerjee A, Narula J, Pinto FJ, Wood DA, Sliwa K. Management of Cardiovascular Disease Patients With Confirmed or Suspected COVID-19 in Limited Resource Settings. Glob Heart. 2020 Jul 1;15(1):44. doi: 10.5334/gh.823. Erratum in: Glob Heart. 2020 Aug 07;15(1):54. PMID: 32923338; PMCID: PMC7413193. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395:1054-1062. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497- 506. doi:10.1016/S0140-6736(20)30183-5 Xiong T-Y, Redwood S, Prendergast B, Chen M. Coronaviruses and the cardiovascular system: acute and long-term implications. European Heart Journal. 2020. DOI: https://doi.org/10.1093/eurheartj/ ehaa231 Musher DM, Abers MS, Corrales-Medina VF. Acute Infection and Myocardial Infarction. N Engl J Med. 2019;380(2):171-176. doi:10.1056/NEJMra1808137 Tavazzi G, Pellegrini C, Maurelli M, et al. Myocardial localization of coronavirus in COVID-19 cardiogenic shock. Eur J Heart Fail. 2020;22(5):911-915. doi:10.1002/ejhf.1828 Guo T, Fan Y, Chen M, et al. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19) [published online ahead of print, 2020 Mar 27]. JAMA Cardiol. 2020;5(7): 1-8. doi:10.1001/jamacardio.2020.1017. Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020;17(5):259-260. doi:10.1038/s41569-020- 0360-5 Dweck MR, Bularga A, Hahn RT, et al. Global evaluation of echocardiography in patients with COVID-19 [published online ahead of print, 2020 Jun 18]. Eur Heart J Cardiovasc Imaging. 2020;jeaa178. doi:10.1093/ehjci/jeaa178 Chen T, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020;368:m1295. Published 2020 Mar 31. doi:10.1136/bmj.m1295 Chen T, Wu D, Chen H, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study [published correction appears in BMJ. 2020 Mar 31;368:m1295]. BMJ. 2020;368:m1091. Published 2020 Mar 26. doi:10.1136/bmj.m1091 Nishiga M, Wang DW, Han Y, Lewis DB, Wu JC. COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives [published online ahead of print, 2020 Jul 20]. Nat Rev Cardiol. 2020;1-16. doi:10.1038/s41569-020-0413-9 Mehra MR, Ruschitzka F. COVID-19 Illness and Heart Failure: A Missing Link?. JACC Heart Fail. 2020;8(6):512-514. doi:10.1016/j.jchf.2020.03.004 Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14. doi:10.1016/j.echo.2014.10.003 American College of Cardiology Foundation Appropriate Use Criteria Task Force; American Society of Echocardiography; American Heart Association; ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriate Use Criteria for Echocardiography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance American College of Chest Physicians. J Am Soc Echocardiogr. 2011;24(3):229-267. doi:10.1016/j.echo.2010.12.008 Skulstad H, Cosyns B, Popescu BA, 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;21(6):592-598. doi:10.1093/ehjci/jeaa072 Kirkpatrick JN, Mitchell C, Taub C, Kort S, Hung J, Swaminathan M. ASE Statement on Protection of Patients and Echocardiography Service Providers During the 2019 Novel Coronavirus Outbreak: Endorsed by the American College of Cardiology. J Am Coll Cardiol. 2020;75(24):3078- 3084. doi:10.1016/j.jacc.2020.04.002 Hung J, Abraham TP, Cohen MS, et al. ASE Statement on the Reintroduction of Echocardiographic Services during the COVID-19 Pandemic. J Am Soc Echocardiogr. 2020;33(8):1034-1039. doi:10.1016/j.echo.2020.05.019 López H, Ramos C, Casco J, Zúñiga B, Fernández L. Asociación Hondureña de Cardiología. Asociacionhondurenadecardiologia.org. https://asociacionhondurenadecardiologia.org/consenso enfermedad cardiovascular y covid-19 Abril 2020.html#8. Published 2020. Accessed August 18, 2020. Mallea GG., D'Ovidio, A., Ricardo, R., Gustavo, B., Titievsky, L., Nayi, J., Mosso, G., Garófalo, P., Camuzzi, S. and Linero, N., 2020. Recomendaciones Sobre El Uso, Indicaciones, Precauciones Y Protección Del Ultrasonido Cardíaco, Vascular Y Pulmonar Durante La Pandemia De Coronavirus COVID-19. [online] Fac.org.ar. Available at: <https://www.fac.org.ar/cientifica/coronavirus/pdf/US-Covid19-%20PUB%20FAC%20Web.pdf> [Accessed 18 August 2020]. Thygesen K, Alpert JS, Jaffe AS, et al. Fourth Universal Definition of Myocardial Infarction (2018) [published correction appears in Circulation. 2018 Nov 13;138(20):e652]. Circulation. 2018;138(20):e618-e651. doi:10.1161/CIR.0000000000000617 Matulevicius SA, Rohatgi A, Das SR, Price AL, DeLuna A, Reimold SC. Appropriate use and clinical impact of transthoracic echocardiography. JAMA Intern Med. 2013;173(17):1600-1607. doi:10.1001/jamainternmed.2013.8972 Urrea JK, Benítez LM, Ruiz H, Barrera Á, Urrea CA, García ÁA. Evaluación de los criterios apropiados para la indicación de ecocardiografía de estrés en un centro cardiovascular de referencia. Revista Colombiana de Cardiología. 2016;23(2):77-81. doi:10.1016/j.rccar.2015.05.009 Lazzeri C, Cianchi G, Bonizzoli M, Batacchi S, Peris A, Gensini GF. The potential role and limitations of echocardiography in acute respiratory distress syndrome. Ther Adv Respir Dis. 2016;10(2):136-148. doi:10.1177/1753465815621251 Repessé X, Vieillard-Baron A. Right heart function during acute respiratory distress syndrome. Ann Transl Med. 2017;5(14):295. doi:10.21037/atm.2017.06.66 Repessé X, Vieillard-Baron A. Right heart function during acute respiratory distress syndrome. Ann Transl Med. 2017;5(14):295. doi:10.21037/atm.2017.06.66 29. Szekely Y, Lichter Y, Taieb P, et al. The Spectrum of Cardiac Manifestations in Coronavirus Disease 2019 (COVID-19) - a Systematic Echocardiographic Study [published online ahead of print, 2020 May 29]. Circulation. 2020;10.1161/CIRCULATIONAHA.120.047971. doi:10.1161/CIRCULATIONAHA.120.047971 Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015; 28:1-39.e14. Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016;29(4):277-314. doi:10.1016/j.echo.2016.01.011 González-Del-Hoyo M, et al. Echocardiography in the acute phase of COVID-19 infection: impact on management and prognosis. Rev Esp Cardiol. 2021. https://doi.org/10.1016/j.rec.2021.11.012 Benyounes N, Van Der Vynckt C, Tibi S, et al. Echocardiography in Confirmed and Highly Suspected Symptomatic COVID-19 Patients and Its Impact on Treatment Change. Cardiol Res Pract. 2020;2020:4348598. Published 2020 Sep 16. doi:10.1155/2020/4348598 Karagodin I, Carvalho Singulane C, Woodward GM, et al. Echocardiographic Correlates of In-Hospital Death in Patients with Acute COVID-19 Infection: The World Alliance Societies of Echocardiography (WASE-COVID) Study. J Am Soc Echocardiogr. 2021;34(8):819-830. Churchill TW, Bertrand PB, Bernard S, et al. Echocardiographic Features of COVID-19 Illness and Association with Cardiac Biomarkers. J Am Soc Echocardiogr. 2020;33(8):1053-1054. doi:10.1016/j.echo.2020.05.028 R Agarwal, G Priyonugroho, S Hertine, S H Wicaksono, P Almazini, D Zamroni, H S Muliawan, The association between transthoracic echocardiographic parameters and severity of COVID-19 in hospitalised adults - a retrospective analysis, European Heart Journal, Volume 43, Issue Supplement_1, February 2022, ehab849.003, https://doi.org/10.1093/eurheartj/ehab849.003 Díaz JJS, Rincon JM, López MAR, et al. Echocardiographic 60-day mortality markers in patients hospitalized in intensive care for COVID-19 [published online ahead of print, 2022 Jan 3]. Heart Lung. 2022;52:123-129. doi:10.1016/j.hrtlng.2021.12.007 Patil HR, Coggins TR, Kusnetzky LL, Main ML. (2012). Evaluation of appropriate use of transthoracic echocardiography in 1,820 consecutive patients using the 2011 revised appropriate use criteria for echocardiography. Am J Cardiol, 109(12):1814-1817. |
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Universidad Nacional de Colombia |
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Bogotá - Medicina - Especialidad en Medicina Interna |
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Departamento de Medicina Interna |
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Facultad de Medicina |
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Bogotá, Colombia |
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Universidad Nacional de Colombia - Sede Bogotá |
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Atribución-NoComercial 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Méndez Toro, Arnold474df9d251165c00b5d02dc09d91a4af600Amaris Peña, Oscar Ernestoc23bfcd68500b415be50364e2a366203600Ruano Cadena, Andrés9cd787aba73792cbf2f533987e489aa36002022-02-11T16:45:17Z2022-02-11T16:45:17Z2022-02-10https://repositorio.unal.edu.co/handle/unal/80949Universidad Nacional de ColombiaRepositorio Institucional Universidad Nacional de Colombiahttps://repositorio.unal.edu.co/ilustraciones, gráficas, tablasIntroducción: En Diciembre de 2019 se documentó el inicio de la epidemia de Coronavirus (SARS-COV2), con origen en Wuhan, China. En época de pandemia es de vital importancia definir qué tan apropiada es la indicación y urgencia de un ecocardiograma, así como determinar si hay un impacto clínico sobre el paciente. Materiales y métodos: Se revisaron los registros ecocardiográficos de casos sospechosos y confirmados de SARS-Cov2. Se obtuvo variables demográficas, y clínicas. De los confirmados se obtuvo variables bioquímicas y ecocardiográficas asociadas a mortalidad. Se obtuvo las indicaciones más frecuentes del ecocardiograma según las guías ACCF 2011, ASE 2020 y otras indicaciones urgentes construidas a partir de otras sociedades científicas. Se midió el impacto registrando si hubo cambio en la conducta. Las indicaciones del ecocardiograma y el impacto clínico fueron evaluadas por dos cardiólogos, en caso que no concordaran, un tercero evaluó estos casos. Se midió la concordancia mediante índice kappa. Resultados: De los 149 pacientes confirmados, la mediana de edad fue de 66 años (RIQ 56-73). La mediana de estancia hospitalaria fue de 13 días (RIQ 6-23). El 47% fueron mujeres. La mortalidad general y de UCI fue de 39,6% y 60% respectivamente. La fracción de eyección ventrículo izquierdo fue de 60% (57-65), 10% tenían trastornos segmentarios de la contractilidad. 100 pacientes tenían disfunción diastólica, el 72% grado I, el 19% grado II, el 7% grado III. Respecto a las cavidades cardíacas derechas, el 26,8% tenían dilatación o signos de sobrecarga del ventrículo derecho y la PSAP fue de 46 mmHg (RIQ 41-51). Las variables asociadas a mortalidad fueron el recuento leucocitario, los linfocitos, neutrófilos, LDH y PCR. La dilatación o sobrecarga del ventrículo derecho fue la única variable ecocardiográfica asociada a mortalidad (p=0.008). Para las indicaciones según ACCF 2011, el índice kappa de los cardiólogos 1 y 2 fue de 0,798, que muestra un grado bueno de concordancia para clasificar las indicaciones como apropiada, inapropiada e incierta. En 165 pacientes (79.7%) hubo un cambio en la conducta. Por otra parte, al agrupar las indicaciones según la ASE 2020, 205 (99%) fueron de prioridad alta, y de estas el 80% tuvieron un cambio en la conducta. La concordancia entre cardiólogos de estas indicaciones alta (kappa=0.96). Para el impacto clínico hubo una concordancia importante (kappa=0,887) Discusión y conclusiones: Las características clínicas de los pacientes con SARS-Cov2 fueron similares a las de otros estudios publicados. La elevación de diferentes biomarcadores es similar a otras series reportadas. La mortalidad global y en UCI de estos pacientes es considerable, lo que indica la complejidad de la patología y el manejo de esta entidad. La dilatación y/o sobrecarga del ventrículo derecho fue el único hallazgo ecocardiográfico asociado a mortalidad. El impacto clínico fue mayor con las indicaciones apropiadas, sin embargo, también hubo cambios en la conducta con indicaciones inapropiadas, lo cual puede corresponder a vacíos en la información que en ocasiones no son consignados completamente en los registros clínicos, así como escenarios específicos no descritos en las guías de manejo, lo que muestra que las indicaciones ACCF 2011 pueden ser limitadas en este grupo de pacientes. (Texto tomado de la fuente).Introduction: In December 2019, Coronavirus (SARS-CoV2) epidemic started, originating in Wuhan, China. During pandemic, it is important to define the appropriateness of the indication and urgency of an echocardiogram, as well as to determine if there is a clinical impact on the patient. Materials and methods: The echocardiographic records of suspected and confirmed SARS-Cov2 cases were obtained. Demographic and clinical variables were acquired. Of those positive for SARS-CoV2, biochemical and echocardiographic variables associated with mortality were obtained. The most frequent indications of the echocardiogram were collected according to the ACCF 2011, ASE 2020 guidelines and other urgent indications built from other scientific societies. Clinical impact was measured by recording whether there was a change in clinical decisions. The indications of the echocardiogram and the clinical impact were evaluated by two cardiologists. In case they did not agree, a third evaluated these cases. Agreement was measured using the kappa index. Results: Of the 149 confirmed patients, the median age was 66 years (IQR 56-73). The median hospital stay was 13 days (IQR 6-23). 47% were women. Overall and ICU mortality was 39.6% and 60%, respectively. Left ventricular ejection fraction was 60% (RIQ 57-65), 10% had segmental changes in contractility. 100 patients had diastolic dysfunction, 72% grade I, 19% grade II, 7% grade III. Regarding the right heart chambers, 26.8% had right ventricle dilatation or signs of overload. Pulmonary artery systolic pressure was 46 mmHg (IQR 41-51). The variables associated with mortality were leukocyte count, lymphocytes, neutrophils, LDH and CRP. Right ventricular dilatation or overload was the only echocardiographic variable associated with mortality (p=0.008). For the ACCF 2011 indications, the kappa index of cardiologists 1 and 2 was 0.798, which shows a good degree of agreement to classify the indications as appropriate, inappropriate and uncertain. In 165 patients (79.7%) there was a change in behavior. On the other hand, when grouping the indications according to the ASE 2020, 205 (99%) were of high priority, and of these, 80% had a change in clinical decisions. Agreement between cardiologists for these indications was high (kappa=0.96). For clinical impact there was significant agreement (kappa=0.887). Discussion and conclusions: The clinical characteristics of patients with SARS-Cov2 were similar to those of other published studies. The elevation of different biomarkers is similar to other reported series. The overall and ICU mortality of these patients is considerable, which indicates the complexity of the pathology and management of this entity. Dilation and/or overload of the right ventricle was the only echocardiographic finding associated with mortality. The clinical impact was greater with the appropriate indications, however, there were also changes in clinical decisions with inappropriate indications, which may correspond to information gaps that are not fully recorded in the clinical records, as well as specific scenarios not described in the management guidelines, which shows that the ACCF 2011 indications may be limited in this group of patients.Incluye anexosEspecialidades MédicasEspecialista en Medicina InternaRevisión de registros ecocardiográficos y clínicos realizados en el Hospital Universitario Nacional de Colombia. Estudio descriptivo de corte transversal con intencionalidad analítica.x, 76 páginasapplication/pdfspaUniversidad Nacional de ColombiaBogotá - Medicina - Especialidad en Medicina InternaDepartamento de Medicina InternaFacultad de MedicinaBogotá, ColombiaUniversidad Nacional de Colombia - Sede Bogotá610 - Medicina y salud::616 - EnfermedadesInfecciones por CoronavirusServicios de SaludCoronavirus InfectionsHealth ServicesDiagnosis, ultrasonicDiagnóstico ultrasónicoSARS-CoV2COVID-19EcocardiografíaImpacto clínicoUso apropiadoSARS-CoV2COVID-19EchocardiographyClinical impactAppropriate useCaracterísticas ecocardiográficas, pertinencia e impacto clínico del ecocardiograma transtorácico de los pacientes con infección sospechosa/confirmada por coronavirus-19 (SARS-CoV2) en el hospital universitario nacional de ColombiaEchocardiographic characteristics, relevance and clinical impact of the transthoracic echocardiogram of patients with suspected/confirmed coronavirus-19 disease (SARS-CoV2) at the National University Hospital of ColombiaTrabajo de grado - Especialidad Médicainfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/acceptedVersionTexthttp://purl.org/redcol/resource_type/TMColombiaBiremeZhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. 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