Not so fast: Specialists warn against cardiac imaging for asymptomatic COVID-19 patients

Recent studies, including an analysis published earlier this month in JAMA Cardiology, have found that cardiac MR (CMR) imaging can play a crucial role in detecting signs of myocarditis in individuals who have recovered from COVID-19. However, those studies both involved performing imaging exams on asymptomatic patients—and to some healthcare providers, that represents a significant slippery slope.  

In fact, group of cardiologists and other specialists has penned an open letter on this topic, urging medical societies not to recommend CMR for asymptomatic COVID-19 patients.

The letter is addressed to the American College of Cardiology, American College of Radiology, American Heart Association, European Society of Cardiology, European Society of Radiology, Radiologic Society of North America and others.

“We wish to emphasize that the prevalence, clinical significance and long-term implications of CMR surrogates of myocardial injury on morbidity and mortality are unknown,” wrote Venkatesh L. Murthy, MD, PhD, a professor at the University of Michigan in Ann Arbor, and colleagues. “Further, it is unclear if the elevated T1 and T2 flagged in these studies are clinically significant, particularly in isolation, if treatment is needed, and, if so, what the management should be. These important questions should inspire future prospective studies.”

The letter notes that testing asymptomatic COVID-19 patients should not occur “outside of carefully planned and approved research with appropriate control groups.”

“In light of your societies’ standing in the community and advocacy against low-yield testing and low-value medical care through your sponsorship of the Choosing Wisely, Image Wisely, and other similar campaigns, we request that you offer clear guidance discouraging CMR screening for COVID-19 related heart abnormalities in asymptomatic members of the general public,” Murthy et al. concluded.

The letter can be read here