AUTHORS

MATT JONES, MD

SEAN WHITTY, MD CANDIDATE CLASS OF 2020

 

CONSULTant

DON BYARS, MD (emergency medicine)

 

CONTRIBUTOR

MATT JONES, MD

 

 

limited Transthoracic ECHOCARDIOGRAPHY

Anatomy and Views

 

 

Basic Anatomic Measurements (1)

 

 

 

PARASternal views

 

Parasternal Long Axis (PLA) View

  • How to do it.
    • Left Sternal Border, 3rd - 5th intercostal space
    • Palpate between ribs. If you feel a heartbeat, start with the probe at that point. 
    • If you do not have a clear image, slowly move inferiorly down the left sternal boarder. If still no image, try moving superior. 
    • When you see clear cardiac activity, anchor the probe in place. 
    • Orient probe dot toward right shoulder
    • To optimize your view make slow, small and deliberate movements
      • angle the probe north, south, east and west
      • rotate clockwise and counterclockwise. 
      • Slide medially or laterally
      • be sure to make slow, small and deliberate movements
  • Videos that demonstrate how to PLA

 

Parasternal Short Axis (PSA) View

  • Start from the parasternal long axis position
  • Angle the probe to move the mitral valve to the center of the screen
  • rotate probe 90 degrees toward left shoulder
  • This will likely result in a short axis view at the mitral valve level 
  • Angle the probe toward the cardiac base or apex to visualize the following:
    • Base of heart at level of aortic valve (medial and angle toward base
    • Mitral valve level
    • Papillary Level
    • Apical Level 
  • Other tips:
    • To view the base of the heart clearer, slide the probe medially. 
    • To view the apex cleared, slide probe laterally and drop a rib space. 

 

PARASTERNAL SHORT AXIS VIEW - Aortic Valve Level 

PARASTERNAL SHORT AXIS VIEW - Mitral Valve Level

PARASTERNAL SHORT AXIS VIEW - Papillary Level

PARASTERNAL SHORT AXIS VIEW - Apical Level

Apical views

 

Apical two chamber view

 

apical 3 chamber view

 

Apical four chamber view

apical Five Chamber View

Subcostal Views

 

 

 

 

 

Subcostal four chamber view

 

Subcostal Long 

 

practice subcostal

 

 

References 

(1) Otto, C. M. (2004). Textbook of clinical echocardiography / Catherine M. Otto. Philadelphia: Elsevier Saunders.