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Author: Admin | 2025-04-28
To visualize the heart in the supine position, consider repositioning the patient into the Left lateral decubitus. This will bring the heart away from the sternum and give you better sonographic access.Cardiac Ultrasound Machine PreparationTransducer: Phased Array (AKA “cardiac probe”)Preset: CardiacOne of the most confusing parts of performing cardiac ultrasound (echocardiography) is understanding where the indicator goes on the ultrasound screen and probe orientation.Cardiac Ultrasound Machine Placement: Place the ultrasound machine on the patient’s right side, so you can scan with your right hand and manipulate ultrasound buttons with your left hand.Cardiac Ultrasound Machine and Patient PositioningCardiac Ultrasound AnatomyUnderstanding the general anatomy of the heart is important in helping you to visualize the different ultrasound views we will be performing. In addition, it will help keep you organized throughout the cardiac ultrasound exam.There are a total of 4 chambers in the heart: Right Atrium, Right Ventricle, Left Atrium, and Left Ventricle. These are separated by their respective valves: Tricuspid Valve, Pulmonic Valve, Mitral Valve, and Aortic Valve. With transthoracic echocardiography (TTE) you are able to visualize all of these structures but you will need to keep in mind that the heart is located much more medially (toward the sternum) than you may think.Like this Post?Sign Up For POCUS 101 Updates! Cardiac Ultrasound Views/Echocardiography ProtocolThe 5 main/basic cardiac ultrasound views (Cardiac Windows) of the heart are the Parasternal Long Axis, Parasternal Short Axis, Apical 4 Chamber, Subxiphoid (Subcostal), and IVC Views.Step 1: Parasternal Long Axis (PSLA) ViewThe Parasternal Long Axis View is often abbreviated as PSLA or PLAX. It is usually the first cardiac ultrasound view obtained and will give you an immediate assessment of the general condition of the heart including ejection fraction and overall left and right ventricular sizes. Point the probe indicator toward the patient’s right shoulderPlace the probe at the 4th intercostal space which is approximately the nipple line for males or the inframammary fold to the sternum (females).Hand and Probe position for the Parasternal Long Axis ViewStructures to identify in the Parasternal Long Axis (PSLA) View:RV: Right VentricleLV: Left VentricleLA: Left AtriumAV: Aortic ValveMV: Mitral ValveAO: AortaDA: Descending AortaPericardiumParasternal Long Axis View Structures – IllustrationOptimize the gain to visualize the different chambers of the heart in viewOptimize the depth to makes sure you can see the Descending Aorta.POCUS 101 TIP: If you are having trouble orienting yourself, just remember “the 3 L‘s“: For the Parasternal Long
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