24-11: Parasternal Short-Axis View (PSSA)

Technique

• From the parasternal long-axis position, rotate the transducer 90 degrees clockwise (to the patient’s left) or place the transducer in the 4th or 5th left parasternal intercostal space in a line connecting the left clavicle/shoulder and the right hip (Fig. 24.38).

• Identify the left ventricle (circular), right ventricle (crescent-shaped), and surrounding pericardium (Fig. 24.39).

Abnormal Findings

• Pericardial effusion: Anechoic (black) region noted between the bright pericardium and the walls of the heart (Fig. 24.37).

• Dilated right ventricle: The right ventricle is normally a crescent-shaped structure. A rounded, dilated right ventricle that deforms the rounded left ventricle (creating an “OD” sign) suggests elevated right-sided pressures, as seen with pulmonary emboli and severe pulmonary hypertension (Fig. 24.40).

Pearl

1. The standard parasternal short-axis view is obtained with the image plane at the level of the papillary muscles. Visualization of the papillary muscles should ensure a true transverse section through the left ventricle, and provides a prime location for the evaluation of left ventricular contraction and motion.