ECHO Basics 101: Structures Viewed

LEFT PARASTERNAL LONG-AXIS VIEW

• Anterior right ventricular free wall
• Right ventricular cavity
• Interventricular Septum, including membranous portion
• Left ventricular cavity
• Left ventricular posterior wall
• Mitral valve and apparatus (chordae tendinae)
• Left Atrium
• Aortic valve (right and non-coronary cusps--left cusp often not visible)
• Aortic root (anterior and posterior wall)
• LVOT
• Cornoary Sinus (found on AV groove, next to Posterior MVL)
• Descending thoracic aorta
• Pericardium
• Wall Segments: Basal, Mid, and Apical

RIGHT VENTRICULAR INFLOW VIEW

• Obtained by starting in PLAX and angling anteriorly
• Right Atrium
• Right ventricle
• Tricuspid valve (Anterior and Posterior leaflets)
• Eustachian valve often seen (from IVC)

RIGHT VENTRICULAR OUTFLOW VIEW

• Obtained by starting in PLAX and angling posteriorly
• Right ventricle
• Pulmonic valve
• Main pulmonic artery

PARASTERNAL SHORT-AXIS VIEW

• Left ventricle - all wall segments: Anterior LVFW, Anterior-Lateral LVFW, Posterior-Lateral LVFW, Inferior-Posterior LVFW, Inferior LVFW, and Ventricular Septum
• Interventricular Septum - all wall segments: Anterior VS, Middle VS, Inferior VS
• Right ventricle - all wall segments: Anterior RVFW, Middle RVFW, Inferior RVFW
• Aortic valve - all three cusps: Right coronory cusp, Left coronary cusp, and non-coronary cusp
• Pulmonic valve
• Tricuspid valve (Anterior and Septal leaflets)
• Mitral valve (Anterior and posterior leaflets)
• Papillary muscles (Anterior-Lateral and Posterior-medial)
• Right atrium
• Left atrium
• Interatrial septum
• Left Atrial Appendage
• Pericardium

APICAL FOUR-CHAMBER VIEW

• Left ventricle (septal wall, apex, and lateral wall)
• Right ventricle (free wall)
• Right atrium (Chiari network)
• Left atrium (Coronary sinus - obtained by posterior angulation)
• Mitral valve (Anterior and Posterior leaftlets)
• Tricuspid valve (Anterior and Septal leaflets)
• Interatrial and interventricular septae
• Pulmonary veins

APICAL FIVE-CHAMBER VIEW

• Left ventricle
• Left atrium
• Atrioventricular valves
• Right ventricle
• Right atrium
• Aortic valve
• LVOT
• Ascending aorta

APICAL TWO-CHAMBER VIEW

• Left ventricle (Anterior wall, Inferior wall, and apex)
• Left atrium
• Left Atrial Appendage
• Coronary sinus
• Mitral valve (Anterior and Posterior leaflets)

APICAL LONG-AXIS VIEW

• Left ventricle (septum, posterior wall, apex)
• Left atrium
• Aortic valve
• Ascending aorta
• Mitral valve and apparatus
• Right ventricle (small portion)

SUBCOSTAL FOUR-CHAMBER VIEW

• Left ventricle (septal wall, lateral wall)
• Right ventricle (free wall)
• Left atrium
• Right atrium
• Atrioventricular valves
• Interatrial septum
• Interventricular septum
• 5-Chamber view can be obtained by angling the probe upward
• Useful for confirming septal defects with Doppler

SUBCOSTAL SHORT-AXIS VIEW

• Left ventricle - short axis
• Right ventricle
• Tricuspid valve
• Pulmonic valve
• Right ventricular outflow tract
• Main pulmonary artery

SUBCOSTAL INFERIOR VENA CAVA VIEW

• Inferior vena cava
• Hepatic veins
• Right atrium
• Caudate of liver
• Ligamentum venosum
• Eustachian valve
• Chiari Network
• Useful for collapsing IVC when patient sniffs

SUPRASTERNAL VIEW/NOTCH

• Ascending aorta
• Aortic arch
• Descending aorta
• Brachiocephalic or innominate artery
• Left common carotid artery
• Left subclavian artery
• Right pulmonary artery
• useful in detecting Aortic coarctation