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Accoustic Windows & Planes
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Education>Expert TTE>Image Orientation>Accoustic Windows & Planes>1
The anatomic view of the heart depends upon the acoustic window, the cardiac plane, and the cardiac structure of the ultrasound beam. Acoustic windows can be either transthoracic, transesophageal, epiaortic or epicardial. The ASE-SCA has developed standard nomenclature and views for transesophageal and transthoracic acoustic windows.
From the acoustic windows, a cardiac plane is imaged that contains cardiac structures. The combination of the three descriptors will determine the view of the heart imaged by the ultrasound beam.
Acoustic Windows
The acoustic windows are named for the location of the TTE probe on the chest wall. The windows are:
  • Left parasternal (P) transducer position or window
  • Left apical (A) transducer position or window
  • Subcostal (SC) transducer position or window
  • Suprasternal (SSN) transducer position or window
Acoustic Windows Image
Figures 3. Anatomical views depicting the standard transducer windows. Image source: Echocardiography Pocket Guide: The Transthoracic Examination. Bulwer BE, Jones and Bartlett Publishers, 2011.
The variety of TTE windows allows for scanning of the heart from multiple anatomic positions and is useful in patients with surgical dressings and wounds. Each window will be described in detail along with the corresponding TTE views. As with TEE, there are many off-axis and nonstandard views in TTE. For purposes here, standard views will be discussed.
Cardiac Imaging Planes
The left parasternal window has a long and short axis plane followed by the anatomical structures imaged, whereas the other imaging planes are named by the anatomical structure imaged. Below is a list of the acoustic windows, axis (for parasternal views), and the anatomical structure imaged to name each view.
  • Plane Image
  • Video Image
  • Video
LV Inflow-Outflow Image
Title of Tabs
*Optional Views
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