Apical 4 chamber

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The apical four chamber view is found by placing the transducer on the apex of the heart, near the apical impulse. The general rotation of the heart can be seen in the Parasternal long axis and one can follow a line to the apex of the heart on the patient's left side. Often it helps if the patient rotates to their left so that the heart becomes closer to the transducer.

Example of an apical 4 chamber view

By convention the probe is positioned with the marker to the patient's left axilla so that the left ventricle is shown on the viewer's right side. In the picture the left ventricle is on the top right with the left atrium opening into it through the mitral valve, and the right ventricle is on the left side with the right atrium opening into it through the tricuspid valve. This view is useful to compare the size of the left and right ventricular walls and whether or not a pericardial effusion is present. If a pericardial effusion is present then a dark (non-echogenic) space will be seen between the outer ventricular walls and the pericardial sac.

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Apical 4 chamber view of a normal heart

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