The standard echocardiography windows.pptx
- 2. Objectives • PATIENT POSITION • PLAX VIEW • PSAX VIEW • APICAL VIEWS • SUBCOSTAL VIEW • SUPRASTERNAL VIEW
- 3. PATIENT POSITION • Left lateral decubitus position : to shift the heart laterally • Place a pillow to support the patient on their left side • With head elevated and the left arm is tucked under the head : to spread the intercostal space to obtain a better image .
- 5. Echo windows • Standard position on the chest wall are used for placement of transducer are called echo windows • 2D ECHO WINDOWS: • Parasternal • PLAX • PSAX • Pumonary level • Aortic or basal level • Mitral level • Papillary level • Apical or LV level
- 6. • Apical views • Apical 4 chamber • Apical 5 chamber • Apical 2 chamber • Apical 3 chambber • Subcostal • Suprasternal view
- 8. PLAX – Parasternal long axis view • The ultrasound bisects the long axis of both aortic and mitral views • Most of the echo studies begin with this view • This PLAX view sets for the subsequent echo views • Probe position : the transducer placed on left sternal edge between 3-4 Intercostal spaces • Marker point direction : towards the left shoulder
- 9. Views seen under PLAX VIEW • Right ventricle outflow tract • Interventricular septum • Left ventricle (except apex) • Mitral valve leaflet ( anterior and posterior mitral valve leaflet ) • Aortic valve ( right and non coronary cusps ) • Aortic root • Left atrium • Left ventricle posterior wall • Descending aorta as a cross section view
- 12. PSAX • Transducer position : The transducer should be position at the left sternal edge 3-4 Intercostal spaces • Marker dot direction : points towards the left shoulder • Obtaining PSAX from PLAX : Rotate the transducer 90 degree in clockwise direction from PLAX . • By tilting the transducer between the left hip and the right shoulder ,we obtain short axis views at different levels
- 13. PSAX – PULMONARY ARTERY • Structures seen : • Bifurcation of right and left pulmonary artery • Pulmonary valve • Right ventricle outflow tract .
- 16. PSAX- AORTIC VALVE • By tilting the transducer towards the apex • Structures seen • Aortic valve orifice • Aortic valve cusps • Left atrium • Interatrial septum • Right atrium • Right ventricle outflow tract • Pulmonary valve • Pulmonary artery
- 18. PSAX – MITRAL VALVE • Tilting the transducer towards the apex • Structures seen : • Mitral valve orifice • Anterior and posterior mitral leaflets • Interventricular septum
- 20. PSAX – PAPILLARY MUSCLE LEVEL • Tilting the transducer even towards the apex • Structures seen : • Anterolateral papillary muscle • Posteromedial papillary muscle • Interventricular septum
- 22. PSAX- APICAL VIEW STRUCTURE SEEN : • LV APEX
- 24. APICAL VIEWS • For apical views , the subject turns back rightwards from the left lateral position and lies more supine .
- 25. APICAL 4 CHAMBER • TRANSDUCER POSITION : Transducer place at the apex of the heart • Marker dot direction : points towards the left shoulder • Structure seen : • Right ventricle • Left ventricle • Interventricular septum • Right atrium • Left atrium • Interatrial septum • Mitral valve • Tricuspid valve
- 28. APICAL 2 CHAMBER • PROBE POSITION : Positioned at the apex of the heart • Rotate the transducer in 45 degree anticlockwise direction from apical 4 chamber . • STRUCTURES SEEN : • Left ventricle • Left atrium • Mitral valve
- 32. APICAL 3 CHAMBER • Rotate the transducer even further 45degree counterclockwise direction from the 2 chamber view • Structures seen : • Left atrium • Left ventricle • Mitral valve • Aortic root
- 35. APICAL 5 CHAMBER It is obtained after the AP4CH view by slight downward (caudal) tilting of the trasducer Structures seen : • Right and left atrium • Right and left ventricle • LV Outflow tract • Aortic valve • Proximal aorta
- 38. SUBCOSTAL VIEW • PATIENT POSITION : Supine position with head slightly low ;with feet on the bed ; knees are slightly elevated • Better images are obtained with the abdomen relaxed during respiration. • Transducer position : the transducer placed at the xiphi sternum • Marker dot direction : towards the left shoulder . • Structures seen : • Right and left atrium • Right and left ventricle
- 41. SUPRASTERNAL VIEW • Patient Position : supine position with neck hyperextended head is rotated slightly towards the left • POSITION : Transducer should place on the suprasternal notch • Marker dot direction : point towards the left jaw. • Structures seen : • Ascending aorta • Aortic arch • Descending aorta
- 44. References • Echo made easy – 3rd edition – Atul Luthra
- 45. THANK YOU ….