Parasternal Long Axis view (PLAX)

place the transducer approximately on the 3rd intercostal space left parasternal. The transducer's index mark is directed towards the patient's right shoulder (approximately 11 o’clock). The right (RV) and the left ventricle (LV), as well as the aortic bulb (Ao) and the left atrium (LA) can be displayed.

Dx aortic root pathology

Parasternal Long axis view of the RV outflow tract

Parasternal Long axis view of the RV inflow tract

Parasternal Short Axis view (PSAX)

at different levels:

1. Level of papillary muscles
2. Mitral valve
3. Level of aortic valve

Parasternal short axis views of the left ventricle

To assess the relative shapes and sizes of the two ventricles in suspected PE, and to visually assess LV function, both globally and regionally, by looking for abnormal wall motion. It’s also useful for confirming suspected pericardial effusion.

The LV should be round and the RV crescent shaped, like a reverse letter ‘D’. This relationship is reversed in acute cor pulmonale due to pulmonary embolism.

Apical Four Chamber View (A4C)

marker at 3 o'clock

for the identification of pericardial effusions and demonstrating tamponade physiology (right sided diastolic chamber collapse), as well as RV dilation in massive and submassive pulmonary embolism.

Apical Two Chamber View (A2C)

view by rotating the transducer approximately 45 to 90 degrees anticlockwise: probe marker to 12 o’clock

This visualizes the true anterior and true inferior walls of the left ventricle which is important for the assessment of regional wall motion abnormalities.