Parasternal Long Axis View (PLAX)

Great, now that you have the subcostal view down, let's move up the chest to the 3rd-4th intercostal spaces and look for the Parasternal LONG axis view. This view is conveniently named as we will be directing our beam along with the LONG axis of the heart. Place your probe marker to the patient's RIGHT shoulder. Should you place it to the LEFT shoulder, you'll be in the Parasternal Short Axis, which is the NEXT topic.


Start Fishing!

It may take a little fishing to find this view -- make some subtle tilts, rotations and movements to bring it into view. Remember, finesse is the name of the game here, and millimeter adjustments can make or break the image. Memorize the view you're trying for, then match it up to the patient's heart. Oh and remember, you want to back that depth off to about 5-7 cm now...we're not scanning as far away in this shot!


Here's the position you'd like to imitate (remember, probe marker to the patient's RIGHT shoulder)

And here's what you'll see on the screen:

1. A sliver of the RV at the top of the screen

2. A large LV at the bottom left (and this one is quite globular. See the chordae tendinae?)

3. A moderate sized LA at bottom right

4. The mitral valve (flapping at bottom of the screen)

5. The aortic valve accepting blood from the Left Ventricular Outflow Tract (LVOT)

6. No large pericardial effusion, and decent wall motion in all ventricles (important to note)


Any idea what the dark circle at the bottom center of the screen might be? Think about it for a second, then click here for the answer...

Alright, onto our next view...the parasternal short axis (much easier than the long axis)