The parasternal long axis view (PLAX) is obtained from position 3 by aiming the orientation marker of the transducer at the patients right shoulder

In this view these cardiac structures can be visualized:
– Left atrium (LA)
– Left ventricle (LV)
– Right ventricle (RV)
– The aortic root (AO)
– The mitral valve

The parasternal long axis view (PLAX) on the right shows how the image should appear by convention on the screen

Observe the base of the heart at the right side of the screen, and the apex of the heart at the left side of the screen – in contrast to the subcostal 4-chamber view

In this view the aortic (AO) and mitral valves (MV) can be evaluated

The parasternal long axis view is suitable for a quick evaluation of:
– Pathology
– Wall thickness (M-mode)
– Chamber dimensions (M-mode)
– Mitral septal separation (M-mode)
– Aortic and mitral valves

The pleural views are obtained from position 4

As part of the FATE examination these structures should be visualized:
– Liver (right side)
– Spleen (left side)
– Diaphragm (both sides)

The subcostal 4 chamber view on the right shows how the image by convention should appear on the screen

Observe the liver lying “above” the heart, and the base of the heart at the left side of the screen, and the apex of the heart at the right side of the screen

The subcostal 4-chamber view is suitable for a quick qualitative evaluation of:
– Pathology
– Wall thickness
– Chamber dimensions
– Bi-ventricular function

The apical 4-chamber view is obtained from position 2

In this view these cardiac structures can be visualized:
– Left atrium (LA)
– Right atrium (RA)
– Left ventricle (LV)
– Right ventricle (RV)

The apical 4 chamber view on the right shows how the image by convention should appear on the screen

This view is suitable for a quick qualitative evaluation of:
– Pathology
– Wall thickness
– Chamber dimensions
– Bi-ventricular function

At the left parasternal position – FATE position 3 – two different views are obtained

1) The parasternal long axis view (PLAX)

2) The parasternal short axis view (PSAX)

Sliding of the probe can take place in any direction

When sliding the probe no other movements should occur

For sliding instruction a secondary reference point is important

Example:
To get the correct parasternal long axis view the probe should often be closer to the sternum

You will therefore often hear the supervisor saying: “Slide towards the sternum”

A full basic FATE examination includes images of the heart and pleura obtained from four different positions, or “windows”, on the thorax

From these positions 6 imaging views can be achieved:
– Position 1: Subcostal 4-chamber view
– Position 2: Apical 4-chamber view
– Position 3: Parasternal views. The long-axis and short-axis view
– Position 4: Pleural views. Right pleura and left pleura

This lesson will give an overview of the 6 imaging views and how to achieve them

The FATE card is made to assist your memory

The FATE card shows you:
– Where to place the transducer on the thorax for each of the four
positions
– The direction of the transducer orientation marker (OM)
– The rotation of the transducer
– The expected sonographic image

Standard cardiac abbreviations used throughout the course:
LA = left atrium
RA = right atrium
LV = left ventricle
RV = right ventricle
AO = aorta
IVS = interventricular septum
IAS = interatrial septum

You can download the FATE card from Google Play or the AppStore