<p begin="00:00:07.106" end="00:00:08.866" style="s2">- [Voiceover] A phased array<br />transducer with a cardiac</p>
<p begin="00:00:08.866" end="00:00:12.916" style="s2">exam type, is used to<br />perform parasternal long axis</p>
<p begin="00:00:12.916" end="00:00:14.778" style="s2">view of the heart.</p>
<p begin="00:00:14.778" end="00:00:17.654" style="s2">If possible, place the<br />patient in a left lateral</p>
<p begin="00:00:17.654" end="00:00:21.151" style="s2">decubitus position to<br />reduce any lung artifact,</p>
<p begin="00:00:21.151" end="00:00:24.731" style="s2">and to bring the heart closer<br />to the anterior chest wall.</p>
<p begin="00:00:24.731" end="00:00:27.664" style="s2">Place the transducer at the<br />third, or fourth, intercostal</p>
<p begin="00:00:27.664" end="00:00:31.090" style="s2">space immediately left of the sternum.</p>
<p begin="00:00:31.090" end="00:00:33.750" style="s2">Move between the third, and<br />fourth intercostal space,</p>
<p begin="00:00:33.750" end="00:00:37.596" style="s2">and slide the transducer toward,<br />and away from the sternum</p>
<p begin="00:00:37.596" end="00:00:40.566" style="s2">to identify the optimal scanning window.</p>
<p begin="00:00:40.566" end="00:00:43.524" style="s2">Assuming the long axis of the<br />heart to be positioned on a</p>
<p begin="00:00:43.524" end="00:00:46.849" style="s2">plane from the patients right<br />shoulder to left hip, rotate</p>
<p begin="00:00:46.849" end="00:00:49.196" style="s2">the transducer to adjust for the body</p>
<p begin="00:00:49.196" end="00:00:51.410" style="s2">habitus of the patient.</p>
<p begin="00:00:51.410" end="00:00:53.859" style="s2">The orientation marker,<br />will be at approximately</p>
<p begin="00:00:53.859" end="00:00:56.177" style="s2">the 10 o'clock position.</p>
<p begin="00:00:56.177" end="00:00:59.571" style="s2">As an alternative approach,<br />this exam may be performed using</p>
<p begin="00:00:59.571" end="00:01:02.742" style="s2">an abdomen exam type, with<br />the orientation marker</p>
<p begin="00:01:02.742" end="00:01:05.027" style="s2">to the patients right<br />side at approximately</p>
<p begin="00:01:05.027" end="00:01:06.944" style="s2">the 4 o'clock position.</p>
<p begin="00:01:11.288" end="00:01:14.255" style="s2">They myocardium will appear<br />gray, and the blood filled</p>
<p begin="00:01:14.255" end="00:01:17.073" style="s2">chambers will appear hypoechoic.</p>
<p begin="00:01:17.073" end="00:01:20.146" style="s2">The descending aorta is seen<br />in cross section as a round</p>
<p begin="00:01:20.146" end="00:01:24.539" style="s2">structure posterior to the<br />atrioventricular junction.</p>
<p begin="00:01:24.539" end="00:01:27.664" style="s2">This view is used to evaluate<br />the right ventricle, left</p>
<p begin="00:01:27.664" end="00:01:31.331" style="s2">ventricle outflow tract,<br />and left ventricle.</p>
<p begin="00:01:31.331" end="00:01:33.811" style="s2">Note overall activity of the heart.</p>
<p begin="00:01:33.811" end="00:01:37.211" style="s2">Any wall motion abnormality,<br />valve abnormalities,</p>
<p begin="00:01:37.211" end="00:01:40.628" style="s2">and the presence of pericardial effusion.</p>