Clarius Classroom

Cardiac Subcostal View

Dr. Oron Frenkel, MD

In patient with hypotension, chest pain, or dyspnea, quickly identify a pericardial effusion. Slide transducer from umbilicus up towards xiphoid process while holding it as parallel to the ground as possible and placing gentle pressure against patient’s abdomen.

Specialties: Cardiology, Emergency Medicine, EMS, Primary Care
Applications: Cardiac
in a patient presenting with dyspnea or hypotension the subcostal view of the heart can quickly identify a pericardial effusion at the bedside to perform the scan i'll take the scanner and place it above the umbilicus but below the xiphoid process and aim it gently towards the left shoulder but parallel to the floor i'll start applying pressure and moving it up towards the diaphragm keeping the transducer flat as i go once i see the heart in good view in the middle of the screen i'll start tilting or fanning the probe until i can see all four chambers of the heart here here i see the liver the right ventricle the right atrium the septum the left ventricle and the left atrium in clear view and there is no fluid around the heart i'll make sure to get a good fan through the entire heart by lifting the back of the transducer up towards the ceiling and down towards the floor and once i've completed a full fan or sweep through the heart i can feel confident i don't see any signs of a pericardial effusion

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