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Background Three‐dimensional (3D) echocardiography is the most accurate echocardiographic method for ventricular chamber quantification. It is unclear how two‐dimensional (2D) techniques perform against 3D technology and whether 2D methods can be extrapolated to obtain 3D data. Methods Retrospective review of transthoracic echocardiography was performed, with comparison of ejection fraction (EF), end‐diastolic volume (EDV), end‐systolic volume (ESV), and 2D strain‐derived global longitudinal strain (GLS) and synchrony index. Results One‐hundred patients were identified. Using 3D echocardiography as reference standard, good correlation was noted with 2D strain‐derived EF (r = 0.89, P < 0.01) and with 2D standard biplane EF (r = 0.90, P < 0.01) and similarly for EDV (r = 0.84 and r = 0.81, respectively, both P < 0.01). Two‐dimensional strain‐derived EDV by 8% and 2D biplane‐derived EDV underestimated by 8% (P < 0.01). In relation to 3D EF, 2D strain underestimated by 2% and 2D standard biplane overestimated by 2% (P < 0.01). There was a negative correlation between GLS and 3D EF (r = 0.84, P = 0.001). On multivariate analysis, 3D EF could be derived from 2D strain [3D EF = 34.345 + (0.125 * EDV) + (−0.289 * ESV) + (−1.141 * GLS)]. Three‐dimensional echocardiography‐derived synchrony parameter (ie, standard deviation from mean time to minimum systolic volume from 16 subvolumes) did not correlate with 2D strain‐derived synchrony index (r = 0.171). Conclusions Two‐dimensional standard biplane and 2D strain EF and EDV strongly correlate with 3D EF and EDV. Although 2D methods are predictive of 3D findings, over‐ and underestimations may occur. Three‐dimensional echocardiography should be used when available.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus) has been reported to cause significant injury to the central nervous system (CNS). Herein, we describe the case of a 48-year-old male with a past medical history of attention-deficit/hyperactivity disorder (ADHD), hypertension, and hyperlipidemia who developed typical symptomatology of normal pressure hydrocephalus (NPH) with cognitive impairment, gait dysfunction, and urinary incontinence after a mild coronavirus disease (COVID-19) infection. The diagnosis was confirmed by imaging and lumbar puncture (LP). The patient was treated with a ventriculoperitoneal (VP) shunt placed by neurosurgery and had a complete recovery.Despite increasing reports of neurological manifestations of COVID-19 infection, the mechanism of such pathology is still not well understood. Hypotheses include viral invasion of the CNS either through the nasopharynx and olfactory epithelium or directly through the blood brain barrier.

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