** For detailed instructions on obtaining the cardiac windows, please revisit the prerequisite KidSONO Introduction to Cardiac Windows Module

Stepwise Technique

1.  Parasternal long axis: Visual assessment of LVfx

i. Assess the overall movement of the LV walls

ii. Observe the anterior mitral valve leaflet (AMVL) and evaluate if it approaches the interventricular septum during diastole

iii. M-Mode: Activate M-mode and place the cursor line through the tip of the AMVL and the septum. Measure EPSS

 

2.  Parasternal Short Axis: Visual assessment of global LVfx & regional wall motion abnormalities 

i. From the MV level sweep the probe all the way to the apex, assessing LVFx and wall motion at each level

– Obtain a representative clip at the mid-papillary level and/or where contractility changes are observed

ii. M-Mode: At the mid-papillary level, place the M-mode curser perpendicularly through the centre of the LV cavity, between the papillary muscles. Calculate fractional shortening

 

3. Apical 4 Chamber: Visual assessment of global LVfx & size

i. Assess the overall movement of the LV walls

ii. Assess which ventricle is making up the apex of the heart (as should be the LV) and compare general size of RV to LV

 

4. Subxiphoid 4 Chamber: Visual assessment of global LVfx & size

i. Assess the overall movement of the LV walls

 

5. Documentation: Store representative clips for each standard view