Subcostal 4 Chamber

How To Obtain This View:

The patient can be placed in the supine or semi-recumbent position with knees flexed and abdominal muscles relaxed. This view may sometimes be uncomfortable for the patient. The transducer is placed in the subcostal region in the midline with the probe marker facing the left flank. The probe is angulated in the direction of the base of the heart.

Useful For Assessment Of:

Left Ventricle:

LV contractility can be assessed, with the lateral wall, septal wall and apical cap visualized.

Right Ventricle:

RV size can be determined. This is also a good view to measure RV wall thickness, a good indicator of chronicity of pulmonary hypertension.

Atria:

Left and right atrial size, as well as presence of atrial septal defects should be evaluated. Look for masses and thrombi. Enlarged LA may be seen in mitral stenosis or regurgitation, diastolic dysfunction and chronic AF.

Pericardial Space:

Pericardial effusions and signs of tamponade can be picked up in this view.