Image obtained from the subcostal 4 chamber view
– Hold the transducer as a screwdriver, prone
– Place it subcostally, slightly to the right of the midline
– OM should be directed towards the patient’s left
– To achieve the correct anatomical alignment, rotate the transducer approx. 20
Memorize the target IVC image before beginning the examination
A schematic drawing of IVC is found at the upper left corner of the extended views on the FATE card
Download the FATE-card here: https://test.usabcd.org/fate-card
Inferior vena cava is another useful view obtained from position 1
The view is suitable for a quick evaluation of:
– IVC dimension
– IVC dynamics with respiration
– Placement of umbilical catheter in neonates
– IVC dynamics for the optimization of fluid responsiveness
For this view the transducer can be held as a screw driver, prone, or in any other position that you feel comfortable with
The subcostal IVC 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 cranially
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 embolism and global function of both the right and the left ventricle
The pathology will be explained later
It is recommended that you start with the subcostal 4CH view and look slightly to the back of the heart (elevating the tail of the transducer)
When you have identified the IVC entry into the right atrium, rotate the transducer counterclockwise until a longitudinal view of the IVC is displayed and the OM is pointing cranially
The FATE position 1, sub-costal 4 chamber view. Observe the similarities, and the differences with respect to biological variation and instrument setting e.g.: gain, TGC, depth and sector angle reflecting individual habits.
In the daily clinical practice it is important to know the blood supply of the heart
Remember the individual variations can be substantial
