Fig. 1: Schematics and representative images demonstrate the landmarks used for acquisitions of the apical 4-chamber-long-axis (A4CLAX) view echocardiography.

The A4CLAX view diagram shows key landmarks of all four chamber of the heart–left ventricle (LV), right ventricle (RV), left atrium (LA), and right atrium (RA)–including ① LV apex, ② mitral valve and annulus, and ③ tricuspid annulus and valve. The parasternal long-axis (PLAX) view was taken with ① clear LV apex as well as ④ aortic outflow (AO) tract. The parasternal short-axis (PSAX) view was taken perpendicular to PLAX view needs visualization of LV and RV as well as papillary muscles at the mid papillary level for consistent image acquisition. The PSAX view representative image also includes M-mode recording plane placement at mid-papillary level.