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|Author||I.A.C. van der Bilt|
|Moderator||I.A.C. van der Bilt|
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How to Get a Good Subcostal View
The subcostal views of the heart allows the assessment of both the left and right sides of the heart, which is not possible with parasternal planes. To get a good subcostal view image, the patient is placed in a supine position. The subcostal view is found by placing the transducer just below the xyphoid, under the ribcage. To obtain the subcostal four chamber view, place the transducer over the center of the epigastrium and tilt it downward from the suprasternal notch to the left shoulder of the patient. The image produced will be similar to the apical four chamber view. The short-axis subcostal view on the other hand is similar to the parasternal view and is ideal for studying the right side of the heart.
Structures Seen in Subcostal View=
The four cardiac chambers, the right ventricular outflow tract, the aorta, and the vena cava can be visualized in the subcostal view. Sometimes, it is also possible to visualize a portion of the abdominal aorta. Pointing the transducer toward the right side of the patient would result in a good view of showing the liver and suprahepatic veins, as well as a transverse cross section of the inferior vena cava.
Purposes of the Subcostal View
The subcostal view is important for the assessment of the presence of emphysema and chronic obstructive lung disease. Defects of the atrial septum is evaluated with the use of this view. Also, the analysis of lateral and inferior wall contractility, apex of the right ventricle, presence of pericardial effusion is done. Wall motion may be assessed at the level of the septum and let ventricular inferoposterior.
|Subcostal view of a normal heart|
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- Petros Nihoyannopoulos (Editor), Joseph Kisslo (Editor). Echocardiography. Springer. isbn:1848822928.