Aurora St. Luke's team develops faster heart ultrasound procedure for COVID-19 patients

In the brutal testing ground of COVID-19, a group of young heart sonographers at Aurora St. Luke's Medical Center developed a way to take accurate heart images of coronavirus patients in almost half the time and with less risk to hospital staff.

The sonographers recently published their method in a professional journal and have been contacted by colleagues at other hospitals interested in adopting the technique.

While COVID-19 was first treated as a disease primarily of the the lungs, doctors rapidly learned that the virus also weakens the right side of the heart.

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"The lungs and the heart are connected to each other. It's like a happy marriage that is also unhappy at times," explained Bijoy K. Khandheria, medical director for the echocardiogram lab at Aurora St. Luke's. "The right side of the heart is where impure blood comes and is sent to the lungs for purification.

"In COVID-19, the lungs become solid and the air exchange is impaired; that impacts the right side of the heart. The right side of the heart starts failing, which is one of the causes of death in these critically ill patients."

The risk to the heart posed by the disease has made it especially important to provide doctors with clear images of the right side of the heart. Producing accurate heart ultrasound scans generally takes about one hour, which is a long time for medical staff to be close to patients with a highly infectious disease.

The method developed by the Aurora St. Luke's team uses cardiac ultrasound machines. The machines, which are roughly the size of a small refrigerator, send ultrasound beams into the chest, which are reflected back to the machine and refined to offer a clear view of the heart. 

The sonographers at Aurora St. Luke's have developed a method that allows them to cut the time needed to take the scans from one hour to 35 minutes or less.

Khandheria drew an analogy to shopping to explain the advantage of the new method: "You can go to a store and browse and pick out whatever you want, or you can go directly to the correct aisle and get what you want without browsing." 

"We follow completely the protective equipment guidelines," said Abigail Kaminski, a 26-year-old heart sonographer on the team that developed the new approach. "We came up with a protocol for the images we need to acquire and need to acquire accurately." 

The other sonographers who worked with Kaminski to develop the method were: Abby Payne, Sarah Roemer, Emily Tanel, Denise Ignatowski and Melissa Salazar. They devised the technique in the first week of April. 

Since then, they have met weekly with Khandheria to collect data and decide whether minor adjustments need to be made in the method. Khandheria said hospitals as far away as India have contacted the group to discuss the protocol. 

By the first week of May, Aurora St. Luke's had scanned about 80 COVID-19 patients in the intensive care unit using the technique the team developed. Khandheria said the majority of the patients scanned are already on ventilators.

"This group of patients is really struggling," he said. "They really are the sickest of the sick."

"It is absolutely essential," he said, that medical staff obtain clear scans of these patients' hearts.