Regional cardiac anatomy

Below we have compiled the key views and relevant anatomy in regional wall motion analysis of the left ventricle. Please note, this page does not explore the wall motion lexicon (i.e. hypokinesis, akinetic, etc) or include the full potential range of possible views available for interrogation. More on this to come!

Parasternal long axis

The parasternal long axis cuts through the long axis of the LV with the septum in the near field and infero-lateral wall in the far field.

Parasternal short axis views

Parasternal short axis (base level)

At the LV base, immediately inferior to the aortic valve, you can see the classic “fish mouth” view of the mitral valve. While the cardiac regions are anterior, inferior, lateral and septal, they are further subdivided as outlined here.

Parasternal short axis (mid level)

This short axis view cuts the ventricle at the level of the papillary muscles.

Parasternal short axis (apex level)

Apical views

Apical 4-chamber

Often one of the most challenging views to understand, the apical 4-chamber should be non-foreshortened and exclude the left ventricular outflow tract. In this perspective, the basal septum is shown (subdivided) and opposing wall is antero-lateral (subdivided again), along with the apical cap.

apical 5-chamber

With either slight fanning or probe rotation, the LVOT is displayed with the aortic valve. Because this view requires to fan or angle the probe cephalad, you now see the anterior portion of the septum (subdivided).

Apical 3-chamber

The apical 3-chamber has essentially the same configuration as the parasternal long axis. Because you can see the aortic valve, the septal portion must be anterior. The opposing wall is infero-lateral (As seen in PLAX).

Apical 2-chamber

This view is 90 degrees from the apical 4-chamber and, if well positioned, should demonstrate the anterior and inferior walls (subdivided).