Standard Parasternal Long Axis View

PLAX probe view.jpg

In this position the ultrasound beam (light blue) cuts the heart like to create the 2D image below 

Place the  transducer just left of the sternum in the 4th or 5th intercostal space. The transducer marker (arrow) should be facing the right shoulder.

PLAXcut.jpg

The most anterior structure is the right ventricular outflow tract (RVOT). The left ventricle (LV), left atrium (LA) and descending aorta are visible below. An ideal PLAX view doesn't show the LV apex and the LV wall are almost horizontal.  Also seen are the anterior and posterior mitral valve leaflets (AML, PML), aortic valve (AV) and descending aorta (DA). 

TTE.PLAX_edited.jpg
PLAX view.jpg

This is a video clip of an ideal view 

Aortic and Mitral Zoomed in View

Zooming in on the aortic valve and mitral valve allows for better visualization of leaflet structures. Usually the right and non coronary cusps of the aortic valve are seen here, however with off-axis imaging, the left coronary cusp may also be seen. RCC - right coronary cusp, NCC - non coronary cusp.

PLAX AV MV ZOOM label.JPG

Ascending Aorta

By moving the transducer up an interspace, one can see the proximal ascending aorta. This is useful in those who have dilated or calcified aorta root and enlarged ascending aorta.