Stress Echo ScanCoach™
Probe Positioning · Wall Motion Scoring · DSE Protocol
View-by-view acquisition guide for exercise and pharmacological stress echocardiography — baseline, peak stress, and recovery phases with Doppler guidance and critical findings.
Select View
PLAX (Rest)
Parasternal, 3rd–4th ICS, left sternal border
The parasternal long axis is the first baseline view. It provides LV dimensions, wall thickness, LVOT diameter, aortic and mitral valve morphology, and a reference for posterior wall and septal motion at rest.
Reference image — PLAX (Rest)
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Probe / Patient
Probe: Parasternal, 3rd–4th ICS, left sternal border
Transducer: Phased array 2–4 MHz
Position: Left lateral decubitus
Structures Visualised
- LV (septum, posterior wall)
- LVOT
- Aortic valve
- Mitral valve (anterior and posterior leaflets)
- Left atrium
- Descending aorta (posterior)
How to Acquire
- 1Position patient in left lateral decubitus
- 2Place transducer at 3rd–4th ICS, left sternal border
- 3Rotate marker toward the right shoulder (10–11 o'clock)
- 4Optimize depth to include the descending aorta posteriorly
- 5Tilt inferiorly to open the LVOT and aortic valve
Doppler Assessment
Tips
- Acquire cine loops of ≥3 cardiac cycles at rest — essential for side-by-side comparison
- Mark end-diastole (QRS) and end-systole (smallest LV) for wall motion scoring
- Ensure the posterior wall and septum are parallel — avoid oblique cuts
Pitfalls
- Oblique PLAX overestimates LV dimensions — ensure parallel walls
- Foreshortened PLAX misses apical WMA — supplement with apical views
Key Measurements
- LVIDd/LVIDs
- IVSd/PWd
- LVEF (visual)
- LVOT diameter
Critical Findings
- Baseline RWMA (pre-existing ischaemia)
- Severe MR at rest
- Significant LVOTO (HOCM)