Apical Five Chamber View:
©Walter Rasmussen, R.D.C.S.
The apical five chamber view is obtained by tilting the transducer slightly anteriorly from the apical 4-chamber view until the aortic root and valve are visible. Although this is called the Apical 5 Chamber view, the primary points of interest are the aortic valve, LVOT, the inter-ventricular septum and the anterior mitral valve leaflet.
If the 5-Chamber view is faint, it is often effective to have the patient inhale to the degree that the aortic valve is shown more clearly. It may be necessary to move the transducer, following the heart as it shifts toward the mid-line.
The main purpose of this view is to visualize the left ventricular outflow tract and aortic valve anatomy with two-dimensional imaging and blood flow characteristics with color Doppler. As blood is ejected from the left ventricle, it is channeled through the LVOT, (formed by the anterior mitral valve leaflet and inter-ventricular septum), and out through the aortic valve. Blood flow can also be evaluated for dynamic LV outflow obstruction from the mid ventricle to the aortic valve with Color Doppler, PW Doppler and CW Doppler.
The 2-D image should demonstrate the aortic valve as it opens and closes, the anterior mitral valve leaflet, the LVOT and the mid-ventricle. A zoomed image of the aortic valve is important for thorough assessment of the valve and can help for a more thorough assessment of sclerosis, calcification, stenotic and prosthetic valves.