to the sternum. Without qualification, this means the left side of the heart but right parasternal views can be attempted. Apical: at the apex of the heart. Subcostal: below the sternum at the top of the abdomen Suprasternal: above the sternal at the base of the neck. Views There are several typical views obtained during a routine TTE. Views outside of the typical views can be considered "off axis" and may be obtained for specific purposes. Parasternal long axis (PLAX) This view is obtained to the left of the sternum and views the heart in its long axis. In this view, the mitral valve, aortic valve, right ventricular outflow tract, base of the left ventricle, and the left atrium can be visible. Angulation in this view can bring the right ventricular inflow tract and tricuspid valve into view, and angulation the opposite way can bring the pulmonary valve into view. In this view, it is possible to appreciate the long-axis cross section of the mitral and aortic valves. The classic "hockey stick" shape of rheumatic mitral stenosis can be appreciated in this view. However, the angle of the probe with these valves can lead to under-appreciation of valve dysfunction. The parasternal long view of the pulmonary valve is the only view of the posterior leaflet. Structures visible: Anterior septal and inferior lateral walls of the left ventricle Left atrium Mitral valve in long-axis with chordae Aortic valve in long-axis Tricuspid valve in long-axis (angulated) and right ventricular inflow tract Pulmonary valve in long-axis (angulated) and right ventricular outflow tract Measurements in this view can be used to quantify the heart: Left ventricular size and wall thickness Left atrial linear dimension (as opposed to area) Left ventricular outflow tract diameter (used to calculate aortic valve area by the continuity equation) Aortic annulus, sinus of Valsalva, and aortic root sizes Color doppler of all four valves Spectral doppler of tricuspid and pulmonary valves Parasternal short axis (PSAX) This view is obtained in the same window as the parasternal long, but with the probe rotated 90°. In this view, the aortic valve is seen in cross-section with the right ventricular inflow & outflow tracts visible with the tricuspid valve as well. Pulmonary valve is not visible in this view. Both the right and left atria are visible. The standard PSAX view is at the level of the aortic valve, but moving the probe