Apical Long Axis

Probe Apical 3 left hand.jpg

Transducer Position: The apical long axis, sometimes called the three chamber view is obtained by rotation of the probe further counter-clockwise from the apical 2 chamber position to point toward the right shoulder. The probe is thus facing around 10 o'clock (arrow). 

Apical 3C cut.jpg

Rotating the probe from the two chamber position now bisects the aortic root and aortic valve.

A3C view.jpg

The anteroseptum now comes into view. Compare this view plane to the parasternal long axis. It is virtually the same except the probe is imaging from the apex. LA - left atrium, MV - mitral valve, LV - left ventricle, RVOT - right ventricular outflow tract. 

A ideal apical long axis view

TTE.A3C.label.JPG

This view shows similar structures to the parasternal long axis except now the LV apex is well visualized and is in the near field. The LV wall segments and views of the aortic and mitral valves are the same. Ao - aorta, AV - aortic valve, LA - left atrium, LV - left ventricle, PML - posterior mitral leaflet, AML - anterior mitral leaflet, and RVOT - right ventricular outflow tract.

In this view the color and spectral Doppler of the aortic valve and mitral valve should be performed. The probe may have better alignment with the flow through the LVOT and aortic valve in this view compared to the 5 chamber view. It is important to assess the velocity time profiles in both views.