The target view is a 4 chamber image corresponding to the scanning plane indicated on the torso in the image
All four chambers are viewed in long axis
As the transducer is placed at the apex both the right (RV) and the left (LV) ventricles appear in the near field and the right (RA) and left (LA) atria appears in the far field
When a 4 chamber view is present on the screen, this is per definition a zero degree rotation
The structures identified in the FATE position 2 – the apical view
– Apex of the heart
– RA: Right atrium
– RV: Right ventricle
– LA: Left atrium
– LV: Left ventricle
– Lateral wall
– Decending thoracic aorta
– Anterior mitral leaflet
– Posterior mitral leaflet
– IVS: Inter-ventricular septum
– IAS: Inter-atrial septum
The probe is placed on the skin, the yellow fan-like sector (the scanning plane) diverges from the probe and intersects the heart
The orientation marker (OM – green arrow) is pointing towards the left side of the patient (the right side of the screen)
To understand how the sector is presented on the screen, imagine that the upper border of the screen is the skin, and the sector diverges from the probe placed on the skin.
The blue radius on the screen corresponds to the blue margin of the yellow fan
The red radius on the screen corresponds to the red margin of the yellow fan
The left ventricle is displayed on the right side of the screen, when the OM is correctly pointing towards the patient
In this video the anatomical structures are indicated on the beating heart
Observe: Liver, apex of the heart, basis of the heart, right atrium, right ventricle, left atrium, left ventricle, inter-ventricular septum, inter-atrial septum.
The apical view is obtained by placing the transducer where the cardiac apex is most easily palpated
The orientation marker on the transducer should be directed towards the patient’s left side
Notice the location of the heart in the thoracic cavity and the orientation of the ultrasound sector beam
Forced inspiration will push the diaphragm down and will usually facilitate the subcostal approach
The subcostal 4 chamber view is suitable for evaluation of pericardial effusion, pulmonary embolus and global function of both the right and the left ventricle
The FATE position 2 is called the apical view
The apical view is a 4 chamber view (A4CH) imaging all 4 chambers of the heart
The position is obtained in position 2 indicated on page 1 of the FATE-card
The apical 4-chamber view is suitable for a quick qualitative evaluation of:
– Pathology (pericardial effusion, pulmonary embolus)
– Wall thickness
– Chamber dimensions
– Bi-ventricular function
You will now be taken through the position in detail, focusing on how to obtain and interpret the right 2D ultrasound image
The structures identified in the FATE position 1 – the subcostal view
– Liver
– Apex of the heart
– Base of the heart
– RA: Right atrium
– RV: Right ventricle
– LA: Left atrium
– LV: Left ventricle
– IVS: Inter-ventricular septum
– IAS: Inter-atrial septum
The subcostal view is obtained by placing the transducer in the subcostal position, slightly to the right of the midline
The orientation marker on the transducer should be directed towards the patient’s left
Notice the location of the heart in the thoracic cavity and the orientation of the ultrasound sector beam (the scanning plane)
