Four-chamber view sweep

4-chamber view. One may appreciate the Right (RV) and Left (LV) ventricles, the corresponding atriums, the mitral valve with the papillary muscles, the tricuspid valve and the inter-ventricular septum. The moderator band of the right ventricle may be seen. Pulmonary vein(s) by 2D and color Doppler (low velocity filter "Nyquist) can also be appreciated. Fetal cardiac systolic function may be appreciated in this view. Mitral/tricuspid valve opening and closure, as well as inflow velocities can be evaluated.

In this sweep - one may see the LVOT, as well as the RV to RVOT connection, branching of the pulmonary trunk.

Here is a view of the RV/LV and corresponding atriums in another axis with opening and closing of the atrio-ventricular valves. Colour Doppler shows filling of corresponding ventricles with no signs of regurgitation. One may perceive (in red) the outflow tract of the LV.

Sweep with colour Doppler showing the RV filling. The probe is doing a sweep so that we can appreciate the LV filling (red) to LVOT ejection (in blue). One may see the filling of the right atrium and as the sweep goes anteriorly, we can appreciate the LV, the LVOT and eventually the RVOT to MPA relationships.

Another sweep with colour Doppler showing the RV filling in red. There is no clear VSD appreciated in this view (although it may be easily missed). The probe is doing a sweep so that we can appreciate the LV filling (red) to LVOT ejection (in blue).

RV and LV inflow velocities

LV inflow velocities. Early and atrial velocities can be evaluated.

RV inflow velocities. Early and atrial velocities can be evaluated.

Another example of inflow velocities of the Right ventricle by PW Doppler.

Another example of inflow velocities of the Left ventricle by PW Doppler.

Pulmonary veins

Pulse Wave Doppler at the level of the right upper pulmonary vein

Pulse Wave Doppler at the level of the left pulmonary vein

Other examples of pulmonary vein Doppler by PW.

Another view of the RV and LV with atrio-ventricular valves.

Sweep from the RV-LV towards the outflow tracts

Sweep from the RV-LV towards the outflow tracts with colour Doppler.

Long axis view of the heart in 2D mode. One may see the LV and an anterior sweep establishing the relationship to the ascending aorta, as well as the RVOT leading to the pulmonary valve and pulmonary artery which is not parallel to the aorta.

Pulsed Wave Doppler tracing at the mitral valve inflow and aortic valve outflow. This allows for measurement of time intervals - evaluating time between the atrial and ventricular contraction. The Atrio-Ventricular and Ventriculo-Atrial time intervals may be measured. More on congenital heart block here.

Another example of the pulsed Wave Doppler tracing at the mitral valve inflow and aortic valve outflow. This allows for measurement of time intervals - evaluating time between the atrial and ventricular contraction. Here is an example of measurements of the AV intervals.

Pulse Wave Doppler at the LVOT. One can measure the ejection time.

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