Description

This view is the conventional starting point of a targeted neonatal echocardiogram. The image acquired illustrates the 4 well recognized cardiac chambers. The images are used to assess mitral valve and tricuspid valve inflow Doppler, and assess left and right outflow tracts. Although the interventricular and interatrial septa are visualized, this view is not ideal for assessing the presence of defects in these walls as there may be artificial drop off in the signal retuning. Modifications of this view enables the examiner to assess the left and right ventricular outflow tract for the presence of stenoses and obtain Doppler signals that may be used in the calculation of the left and right ventricular outputs. To obtain the 4-chamber view, the probe is placed on the apex, at an angle pointing towards the right shoulder. The positioning marker of the probe faces the left shoulder. The operator may need on occasion to move the probe in a more lateral position to obtain this view. This particularly applies to infants a few weeks of age with evolving chronic lung disease. The Doppler loops demonstrate the assessment of the mitral valve, the tricuspid valve, and the interventricular septum (see mitral valve and tricuspid valve Doppler section)