The transducer is placed at the same physical location on the chest was as the Apical 2 chamber view. 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 2 to 3 Chamber Transition
The transducer beam rotated further anti-clockwise (from the apical 2 chamber postion). This brings both the aortic and mitral valves into the same imaging plane.
Left sided chambers with left ventricular outflow.
Left sided chambers with the left ventricular outflow tract (LVOT) and the aortic outflow are visualised.
The basal, mid and apical portion of both the inferolateral and anteroseptal left ventricular walls (6 of 17 segments) are visible.
Colour flow doppler imaging should be applied here to look for/quantify mitral regurgitation. It is also an important view for diagnosis of aortic regurgitation. The LVOT volume time integral (VTI) is determined here by placing the pulsed spectral doppler gate just proximal to the aortic valve. This is used to calculate cardiac output.