Echocardiographic Exam acquisition protocol

An imaging description of the standard echocardiography examination

January 26, 2021
(updated April 29th, 2022)
Pages: 1 – 12

Clinical Echocardiographic Examination ProtocolBrief Operator Guide

General Rules

Please follow the suggested standard viewing sequence, always the same, in every patient you scan: this method increases your accuracy and reproducibility and readability of the exams by your colleagues.
To acquire and maintain a necessary high measurement accuracy, you need to perform all the main measurements in all patients.

It is necessary to save for each view 3 seconds (or 3 heartbeats) video clips, and still images when required (with the performed measurements). The rationale is that it must always be possible to view your measurements on saved examinations, and eventually revise them.

Each exam must have the full patient name

Input patient height and weight. This allows the machine to normalize atrial and ventricular volumes measurements to the BSA (body surface area)

Always connect the ECG cable to obtain a readable ECG trace on the machine.

2D Gain: the blood pool must be black, the pericardium white, the myocardium gray










Acquisition sequence for each view

·  2D imaging video clip (3 heart beats)
·  2D still frame with measurements (if required)
·  Color Doppler video clip
·  M-mode still frame with measurements, if required
·  Pulsed Doppler still frame with measurements, if required
·  Continuous wave Doppler still frame with measurements, if required
·  Dopper Tissue Imaging still frame with measurements, if required


·  2D动态图像(3个节律)
·  2D图像含测量(如果需要)
·  颜色多普勒动图图像
·  M模图像含测量,如果需要
·  脉冲波多普勒图像含测量,如果需要
·  连续波多普勒图像含测量,如果需要
·  组织多普勒图像含测量,如果需要

Figure 1. Available echocardiographic transthoracic views.

Figure 1. The image shows the available echocardiographic transthoracic views.
It is evident that:
– The long axis views of the left and right ventricles from the parasternal and apical (3-chamber) views are equivalent
– The short axis of the left and right ventricles from the parasternal and subcostal views are equivalent
– The 4-chamber views as explored from the apical or subcostal windows are equivalent

Thus, the parasternal imaging in a patient with poor anterior thorax ultrasound penetration (ex: emphysema) can be successfully substituted by apical and especially subcostal imaging.

Imaging Protocol

  • 1. Parasternal Long Axis, left heart … Page 2
  • 2. Parasternal Long Axis, right heart … Page 4
  • 3. Parasternal Short Axis, base of the heart … Page 5
  • 4. Parasternal Short Axis, left ventricle … Page 6
  • 5. Apical Views … Pages 7-11
  • 6. Subcostal Views … Page 12
  • 7. Suprasternal Views … Page 13