Obtaining the Apical Window

Exams began with the apical window. The ultrasound transducer was placed vertically on the left flank with the indicator directed posteriorly, as shown in Figure ​Figure11A. The window was obtained in the traditional apical position, at the point of maximal pulsation near the midclavicular line in the fourth or fifth intercostal space. Once the apical four-chamber view was achieved, an apical five-chamber was obtained by tilting the probe anteriorly. Views were considered adequate if all four chambers (apical four-chamber) and also addition of the left ventricular (LV) outflow tract (apical five-chamber) could be visualized.