Abstract
Children with congenital heart disease will grow into adults who may also develop adult heart disease. This article is reviews the adult two and four chamber echocardiographic views, and is a continuation of the our previous article which dealt with the parasternal views.
MeSH: Echocardiography, Doppler
Paper
An very brief introduction to echocardiographic techniques1 was given in our earlier paper.2
After the parasternal examination,2 the echocardiography study continues with the apical four-chamber view.
Figure 1.
Schematic view of ultrasound beam in the apical 4-chamber view
Figure 2.
Apical 4-chamber (A4C) view. LV=left ventricle, RV=right ventricle, IVS=interventricular septum, LA=left atrium, MV=mitral valve, RA=right atrium, TV=tricuspid valve, IAS=interatrial septum
Figure 3.
Apical 4-chamber (A4C) view angled posteriorly to show the coronary sinus (CS) in the posterior atrioventricular groove. LV=left ventricle, RV=right ventricle, RA=right atrium
Figure 4.
Video clip as per figure 2
The probe is now rotated through 90 degrees and the study continues with the apical two-chamber view.
Figure 5.
Schematic view of ultrasound beam in the apical 2-chamber view (A2C)
Figure 6.
Apical 2-chamber (A2C) view. LV=left ventricle, LA=left atrium, MV=mitral valve
Figure 7.
Video clip as per figure 6
The Doppler study consists of interrogation at mitral, tricuspid and aortic valves with colour and pulse/continuous wave Doppler modalities. It should be borne in mind that red colour codes for velocities towards the probe while blue colour codes for velocities away from the probe.
Figure 8.
Colour Doppler of mitral inflow (arrow represents direction of mitral inflow)
Figure 9.
Left pane shows colour Doppler of mitral inflow. Right panes show pulse wave Doppler of same.
Figure 10.
Colour Doppler of tricuspid inflow (arrow represents direction of tricuspid inflow)
Figure 11.
Video clip as per figure 8
Figure 12.
Apical 5-chamber (A5C) view. LV=left ventricle, RV=right ventricle, LA=left atrium, RA=right atrium, Ao=aorta, AoV=aortic valve
Figure 13.
Video clip as per figure 12
Figure 14.
Colour Doppler of 5-C view
Figure 15.
Aortic Doppler study. Left pane shows location of the continuous wave line while right pane shows Doppler continuous wave signal at that line.
References
- 1.Feigenbaum H. Echocardiography. 6th ed. Philadelphia: Lippincott Williams and Wilkins; 2004. [Google Scholar]