Technical points
The limiting factor in the ultrasound examination of the heart is the size of the lung-free window.
Air-filled lung may prevent adequate echocardiography in cases of obstructive airways disease or chest wall deformity.
There are three classical views:
- left parasternal - in the third and fourth intercostal spaces
- subcostal - below the xiphoid process of the sternum
- apical - over the apex beat (improved when the patient is lying on the left side and exhaling)
Other views:
- suprasternal - for examination of the aortic arch
- transoesophageal - improves overall access
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