Cardiac Subcostal Four Chamber View
On this page we provide training materials and support for the subcostal cardiac window.
This window is the most accessible way of rapidly looking at the heart in ventilated patients. This is because it avoids trying to view the heart through air in the lungs (especially where significant PEEP is being applied). Ultrasound cannot pass through air and the heart can sometimes not be seen with other conventional transthoracic windows such as the parasternal or apical views.
A key disadvantage is that viewing the heart in only one view can lead to limitations in interpretation.
Subcostal four chamber assessment
Allows assessment of:
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Global cardiac function specifically left and right ventricular contractility and function.
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Comparison of the left and right ventricular size
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The presence of a pericardial effusion
From these findings we can flag up any abnormalities to the clinical team and decide whether the patient requires further investigations.
This form shows what questions the INSIGHT scan requires to form an assessment of the overall cardiac function. The IVC assessment has not been described on this page. You can find more information under the Subcostal IVC Window tab.
INSIGHT cardiac questions
INSIGHT cardiac training video
This video will guide you through how to perform a subcostal four chamber INSIGHT scan of the heart.
