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Learning Cardiac Ultrasound Views

By Kvolnuo

January 25, 2026

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First, it is essential to understand the common positions or "acoustic windows" for the cardiac ultrasound probe:

Below, we will further understand cardiac ultrasound views by introducing the scanning methods for various sections of the parasternal long axis and parasternal short axis, as well as the anatomical structures visualized on ultrasound.

Ⅰ. Parasternal Left Ventricular Long-Axis View

The probe is typically placed at the second to fourth intercostal spaces along the left sternal border, with the ultrasound beam parallel to the line connecting the right shoulder and left ribs.

During systole, the internal diameters of different segments of the aortic root can be measured to assess aortic valve pathologies. The anteroposterior diameter of the left atrium is measured during systole to observe tumors or thrombi within the atrium. At the chordal level, the end-diastolic and end-systolic internal diameters of the left ventricle, as well as the thickness and motion amplitude of the interventricular septum and left ventricular posterior wall, are evaluated. The mitral valve leaflets are also assessed.

Ⅱ. Parasternal Aortic Short-Axis View

The probe is positioned at the third or fourth intercostal space along the left sternal border. Based on the parasternal left ventricular long-axis view, the probe is rotated 90° clockwise.

This view is crucial for observing the aortic valve and detecting a patent ductus arteriosus. It allows for measurement of the right ventricular anterior wall thickness and assessment of the right ventricular outflow tract and pulmonary artery. Additionally, it enables visualization of tumors or thrombi within the left and right atria and measurement of the anteroposterior diameter of the left atrium.

Ⅲ. Right Ventricular Inflow Tract Long-Axis View

The probe is placed at the third or fourth intercostal space along the left sternal border. The ultrasound beam is directed toward the xiphoid process and the tricuspid valve, after which the probe is rotated 15° to 30° clockwise along the left ventricular long axis.

This view primarily displays the right atrium, tricuspid valve, right ventricular inflow tract, and right ventricle. It focuses on observing the anterior and posterior leaflets of the tricuspid valve, allowing for evaluation of the structure and function of the tricuspid valve.

IV. Left Ventricular Short-Axis Views

① Mitral Valve Level

The probe is placed at the third to fifth intercostal spaces along the parasternal border. Based on the parasternal aortic short-axis view, the probe is slightly tilted toward the cardiac apex. From anterior to posterior, the image sequentially displays the right ventricular anterior wall, right ventricular cavity, interventricular septum, left ventricle, and mitral valve.

This is the optimal view for measuring mitral valve orifice area and an important view for observing mitral valve leaflet pathologies and segmentation.

② Papillary Muscle Level

The scanning direction is similar to that of the mitral valve level short-axis view, with the probe slightly tilted toward the apex or shifted down by one intercostal space.

This view allows measurement of the thickness and motion amplitude of the mid-ventricular segments. It is commonly used to estimate left ventricular cavity size and assess papillary muscle function.

③ Apical Level

The scanning direction is generally the same as that of the mitral valve and papillary muscle short-axis views. The probe position is usually one intercostal space lower than that of the papillary muscle short-axis view.

This view enables measurement of the thickness and motion amplitude of the apical segments, aiding in the diagnosis of conditions such as apical hypertrophic cardiomyopathy, left ventricular noncompaction, apical thrombus, and ventricular aneurysm.

In this article

Ⅰ. Parasternal Left Ventricular Long-Axis View