Windows

The heart is a structure deeply included in the thorax; it is entirely surrounded by other organs and tissues to increase its security, like the lungs and ribs, which may make an obstacle for the ultrasound propagation rendering the ultrasounds investigation complicated; because of those reasons and to establish a systematic approach for the heart ultrasonography exam, the echocardiographic windows are defined. The term echocardiographic windows refer to a chest wall landmark located in the intercostal spaces or thorax vicinity, where the heart may be explored by ultrasounds. The location of echocardiographic windows may vary according to the morphologic habits, location, and size of the heart, and some pathologic conditions like pneumonectomy. Sometimes no window is possible, which is a limit for transthoracic echocardiography (TTE) exam. In TTE exam, four windows are described: apical, subcostal, parasternal, and suprasternal.