Cardiac ultrasound

Background

• Only ED US when probe marker will be pointing to the left (parasternal views)
• Use phased array probe

Technique

• Parasternal Long
  • Pointer to the L hip, probe at L 3rd/4th intercostal space adjacent to sternum
  • Use to visualize global function and r/o pericardial effusion/tamponade
    • Can evaluate mitral valve, aortic valve, aortic root, LV squeeze

• Parasternal Short
  • Pointer to L shoulder, probe at L 3rd/4th intercostal space adjacent to sternum
  • Tip: obtain parasternal long view, then rotate probe 90 degrees
  • Use to evaluate LV squeeze, R ventricle
    • R heart strain = dilated R ventricle

• Apical 4 chamber
  • Pointer to Right, usually below nipple
  • Use to visualize global function (Left and right ventricle, squeeze)

• Subxyphoid
  • Pointer to Right, subxyphoid with probe pointed toward head
  • Use liver to as acoustic window to visualize heart

• Suprasternal
  • Pointer at 12 o'clock (cephalad) and place in sternal notch
  • Move probe inferior and to the left to visualize aortic arch
  • Rotate probe clockwise for further image optimization
    • Can evaluate for aortic dissections/aneurysms and aortic stenosis/regurg.

Measurements

Aorta

• Normal aortic root is <3.8 cm (parasternal view w/ dot pointing to Lt arm)

See Also

• Ultrasound (Main)
• Pericardial Effusion and Tamponade

Source

Sonosite Uptodate