Echocardiography veiws

Welcome! I am glad you are here to learn about standard echocardiography views. Before we dive into the anatomy and the specific ultrasound windows, I would love to tailor our session to your needs.

What is your current background? Are you a medical student, a healthcare professional, or just curious about the topic?

I am a medical student.

It is great to have you here! As a medical student, mastering the basics of (TTE) is a highly valuable clinical skill. TTE is a non-invasive diagnostic tool that uses ultrasound waves to produce real-time, 2D images of the heart's anatomy, chamber sizes, and overall function, helping clinicians quickly assess hemodynamics and structural abnormalities at the bedside.

Your path

Apical Views

Subcostal and Suprasternal Views

To scan the heart successfully, we rely on specific anatomical regions where the ribs and lungs do not block our ultrasound beam. These are known as the acoustic windows. There are four main acoustic windows we use on the patient's body:

Parasternal window: Located just to the left of the sternum (typically in the 2nd to 4th intercostal spaces).
Apical window: Positioned over the cardiac apex (typically at the point of maximal impulse, or PMI).
Subcostal window: Located just beneath the xiphoid process, using the liver as an acoustic window.
Suprasternal window: Positioned in the dip of the neck just above the breastbone.

Let's start our journey with the Parasternal window and look at our first crucial view: the Parasternal Long-Axis (PLAX) view.

Show me a diagram of these 4 windows

I would be happy to show you how these four standard clinical windows map out on the patient's chest and abdomen.

DIAG

Diagram

While this visual asset is generating, let's explore our first acoustic window in detail: the (PLAX) view. To obtain the PLAX view, you place your transducer in the 2nd to 4th left intercostal space immediately adjacent to the sternum, pointing the probe's orientation marker toward the patient's right shoulder. This slice cuts the heart longitudinally from the base to the apex.

Continue to the key structures visualized in the PLAX view

Let's focus on what you'll actually see on your screen during a (PLAX) scan. Because the ultrasound beam slices vertically from the front of the chest to the back, the structures closest to the probe appear at the top of your screen, while deeper structures sit at the bottom.

Anatomy of the PLAX Screen

When looking at a classic PLAX view, the heart is oriented horizontally across the screen. You can identify the major chambers, valves, and tracts by scanning from the top (anterior) to the bottom (posterior):

Right Ventricle (RV): Positioned at the very top of the sector because it is the most anterior chamber of the heart, lying directly behind the sternum.
Interventricular Septum (IVS): The muscular wall separating the RV at the top from the left ventricle below it.
Left Ventricle (LV): The main, large chamber sitting centrally. You will want to closely observe its thick muscular walls contracting toward the center.
Mitral Valve (MV): Visible inside the LV, showing its anterior and posterior leaflets opening and closing like French doors.
Left Atrium (LA): Located posteriorly and to the right side of the screen, acting as the reservoir that feeds into the LV.
Left Ventricular Outflow Tract (LVOT) and Aortic Valve (AV): To the upper right of the LV, you will see the pathway leading out of the ventricle into the aortic root, where the delicate cusps of the aortic valve open and close.
Descending Aorta: Seen as a small, circular cross-section at the very bottom of the screen, running posterior to the left atrium. This is a critical landmark to help you differentiate a pleural effusion from a .