The transducer is placed at the same physical location on the chest was as the Apical 4 and 5 chamber views. The position is found by palpating the apex beat and then moving laterally and inferiorly (This is particularly relevant in cases of cardiac enlargement). This window is best obtained with the patient in the supine position.
Apical 4 to 2 Chamber Transition
Apical 2 chamber is acquired by anti-clockwise rotation (from the apical 4 chamber). The transducer marker is placed at the twelve o’clock position.
Left sided chambers
Left sided chambers are visible. Note that this is not a true orthogonal plane to the 4 chamber plane. Despite this, it is often combined with the 4 chamber view for bi-plane quantification of ejection fraction.
The basal, mid and apical portions of the anterior and inferior left ventricular walls (6 of 17 segments) are visible. Interventricular and interatrial septa are not visible.
Both mitral valve leaflets are visible. Colour flow doppler imaging should be applied here to look for/quantify mitral regurgitation.