FoCUS = Focused Cardiac Ultrasound

Learning cardiac POCUS starts with mastering a few essential “slicing planes” of the heart – the foundational views every user needs to know to identify common acute pathologies. Once those are second nature, you can move on to the advanced views outlined in the ASE transthoracic echo (TTE) guidelines. And when I say master, I mean it, because in Doppler-based cardiac POCUS (advanced nephrology POCUS), poor grayscale images lead to inaccurate Doppler readings and ultimately patient mismanagement.

You’ll often hear two terms used interchangeably: windows and views. They’re related, but not the same. A window refers to the space on the chest or upper abdomen through which you’re imaging the heart, essentially your acoustic access point. A view, on the other hand, is the actual slice or plane of the heart obtained through that window.

There are three main acoustic windows: left parasternal, apical, and subxiphoid (aka subcostal). Through these, we obtain the core views that form the foundation of cardiac POCUS:

• Parasternal long- and short-axis views
• Apical four- and five-chamber views
• Subxiphoid four-chamber and IVC views

In the short video below, I’ve used 3D-printed heart models to walk through these planes and their orientations – a 10-minute visual guide that’s worth your attention (if your attention span cooperates!).

Below is a nice illustration of cardiac views from PMID 34997377

Here are a few cookie-dough-style renders of the basic cardiac views – just some sweet POCUS treats for your eyes 🍪💛