ASE/SCA 20 Standard Views Flashcards
View name and angle?
ME 4 Chamber View
0-10*
To Obtain the View
Insert probe to the ME / sector depth 14cm, angle 0-10°
Image all 4 heart chambers
Optimize the LV apex by slight retroflexion of probe tip
Ensure no part of the Aortic Valve or LVOT is seen (advance probe)
Aim to maximize the TV diameter, and adjust depth to view entire LV
View name and angle?
ME 2 Chamber View
90*
To Obtain the View
Insert the probe to the ME, sector depth 14cm
From ME 4 chamber (0°) or ME mitral commissural view (60°)
Keep the probe tip still and the MV in the center
Rotate omniplane angle forward to 80-100°
RA + RV disappear, LAA appears
Retroflex probe tip for true LV apex, adjust depth so entire LV apex seen
What sections of the MV are seen?
The anterior (A1 and A2) and posterior (P3) segments of the mitral valve are seen in this view
View name?
ME Mitral Commissural View
What sections of the MV are seen?
P3 scallop (left), P1 scallop (right) and AMVL (usually A2) in the middle
View name and angle?
In the ME LAX view (120°)
To Obtain the View
Insert the probe to the ME, sector depth 14cm
From ME 2 chamber (90°)
Keep the probe tip still and the MV in the center
Rotate omniplane angle forward to 120-130°
AV and LVOT visualized in LAX
Depth adjusted to keep all of LV in view
View name and angle?
ME AV SAX view (30-45°)
To Obtain the View
Insert the probe to the ME, sector depth 8-10cm
Find the ME 4C (0°) withdraw cephalad to obtain the ME 5C view (0°) that includes the LVOT and AV
Rotate omniplane angle to 30-45°
Center aortic valve and aim to make 3 aortic valve cusps symmetric
Withdraw probe for coronary ostia
Advance probe for LVOT
View name and angle?
ME AV LAX view (120°)
Obtain the View
Insert the probe to the ME, sector depth 14cm
Find ME LAX view (120°) decrease depth to focus on aortic root
Can also obtain this view from ME AV SAX (30-60°), rotate omniplane angle to 120 -150°
LVOT, AV, proximal ascending Aorta line up
Optimize aortic annulus and make the sinuses of Valsalva symmetric
View name and angle?
ME Right Ventricular Inflow Outflow View
60-75°
To Obtain the View
Insert the probe to the ME, sector depth 8-10cm
From the ME AV SAX (30-60°)
Rotate the omniplane angle to 60-75°
Optimize TV leaflets, open up RVOT, bring PV + main PA into view
Identify the TV leaflets
anterior/septal (ATVL) on RIGHT
posterior (PTVL) leaflet on LEFT
View name and angle?
ME Bicaval view (90°)
Insert the probe to the ME, sector depth 10-12cm, angle 90-100°
Find ME 2 C (90°)
Turn the entire probe right
Change angle or rotate probe slightly to image both the IVC (left) and SVC (right) simultaneously
View name and angle?
Descending Aorta LAX view (90°)
Insert the probe to the ME, sector depth 4-6cm
From Descending Aorta SAX (0°) view
Keep probe tip still, rotate omniplane angle to 90-100°
Aortic walls appear in parallel
Difficult to tell which wall is right from left and anterior from posterior
View name and angle?
Descending Aorta SAX view (0°)
Insert the probe to the ME, sector depth 10-12cm, angle 0°
Turn probe to left to find the aorta
Put aorta in middle of display
Decrease depth to 5cm
Advance + withdraw probe
View name and angle?
TG mid SAX view (0°)
Insert the probe to the stomach, sector depth 12cm, angle 0°
Advance probe until see stomach (rugae) or liver
Anteflex to contact stomach wall and inferior wall of heart
Center LV by turning probe R or L
Both papillary muscles imaged
Increase the gain to optimize endocardial definition
ID 6 LV segments
Left Ventricular Walls: (opposite segments):inferior (I) « anterior (A), Infero-septal (IS) « Anterolateral (AL), Anteroseptal (AS) « Inferolateral (IL)
View name and angle?
TG 2C view (90°)
Insert the probe to the stomach, sector depth 12cm, angle 0°
Find the mid TG SAX (0°)
Rotate omniplane angle to 90°
Anteflex until LV is horizontal
View name and angle?
TG basal SAX view (0°)
Insert the probe to the stomach, sector depth 12cm, angle 0°
Anteflex the probe to obtain the TG mid SAX view
Withdraw the probe until MV is seen in SAX
Aim to see symmetric MV commisures
View name and angle?
TG LAX view (110-120°)
Insert the probe to the stomach, sector depth 12cm, angle 0°
From TG 2 chamber (90°)
Rotate omniplane angle to 110-120°
May turn probe to right
AV seen on the right side of display, adjust depth
View name and angle?
deep TG LAX view (0°)
Insert the probe to the stomach, sector depth 12cm, angle 0°
From mid or apical TG SAX views anteflex and gently advance probe, hugging the stomach mucosa until the LV apex is seen at the top of the display
Excessive anteflexion brings image plane superior thru base of heart
View name and angle?
In the TG RV inflow view (90°)
the imaging plane is directed longitudinally thru the posterior RV wall to reveal a long axis view of the RV, with the apex of the RV to the display left and the anterior free wall in the far field.
View name and angle?
UE Aortic Arch LAX view (0°)
the imaging plane is directed thru the longitudinal axis of the transverse aortic arch. The circular shape of the descending thoracic aorta changes to an oblong shape of the transverse aortic arch (0°). The proximal aortic arch is to the display left and the distal arch to the right. Further withdrawal may image the great vessels of the head and neck.
View name and angle?
In the UE Aortic Arch SAX view (60-90°)
the imaging plane is directed thru the transverse aortic arch in SAX and the pulmonary artery in LAX. The display shows the proximal origin of the left subclavian artery and innominate vein in the upper right. The pulmonic valve and main pulmonary artery in LAX is seen in the lower left of the display.
View name and angle?
In the ME Ascending Aorta LAX view (90°)
the imaging plane is directed thru the right pulmonary artery to image the proximal ascending aorta in LAX.
Identify 3 structures
Ascending Aorta (AscAo) in LAX
Right Pulmonary Artery (RPA) in SAX
Transverse Pericardial Sinus (PS)
View name and angle?
ME Ascending Aorta SAX view (0°)
the imaging plane is directed slightly above the aortic valve thru the right pulmonary artery (seen in LAX), ascending aorta (seen in SAX) and superior vena cava (seen in SAX).
Identify 4 structures
Main Pulmonary Artery (PA)
Right Pulmonary Artery (RPA)
Ascending Aorta (AscAo) in SAX
Super Vena Cava (SVC) in SAX
Identify the AV leaflets
Aortic Valve: Right (RCC), left (LCC) and non(NCC) coronary cusps
