Saturday, 27 June 2026

Parasternal Left Ventricular Long-Axis View PLVLA (2D Echo )

2D Echo

📄 SonoAcademy

Parasternal Left Ventricular
Long-Axis View (PLVLA,2D)

Parasternal left ventricular long-axis view. (a) Diastole. (b) Systole

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Parasternal Left Ventricular Long-Axis View (PLVLA) is one of the most important standard two-dimensional (2D) transthoracic echocardiographic views. It provides a longitudinal image of the heart, allowing detailed evaluation of the left ventricle, left atrium, mitral valve, aortic valve, left ventricular outflow tract (LVOT), aortic root, interventricular septum, left ventricular posterior wall, and ascending aorta. The PLVLA view is routinely used to assess cardiac anatomy, chamber dimensions, ventricular systolic function, wall thickness, valvular morphology, and aortic root abnormalities. It also serves as the primary reference view for M-mode measurements and quantitative assessment during a comprehensive echocardiographic examination.

1. Introduction

The Parasternal Left Ventricular Long-Axis (PLVLA) view is one of the fundamental transthoracic echocardiographic imaging planes. It provides a long-axis section of the heart, allowing visualization of the left ventricle, left atrium, mitral valve, aortic valve, left ventricular outflow tract (LVOT), aortic root, interventricular septum, and left ventricular posterior wall. This view is essential for routine cardiac examination and quantitative assessment of chamber size, ventricular function, valvular morphology and aortic root pathology.

Commonly Used PLVLA View Abbreviations

Abbreviation	Full View Name
PLVLA	Parasternal Left Ventricular Long-Axis View
PSAX	Parasternal Short-Axis View
A4C	Apical Four-Chamber View
A2C	Apical Two-Chamber View
A3C / APLAX	Apical Three-Chamber View / Apical Long-Axis View
A5C	Apical Five-Chamber View
SC4C	Subcostal Four-Chamber View
IVC	Inferior Vena Cava View
SSN	Suprasternal Notch View

2. Scanning Method

Patient Position

Supine or left lateral decubitus position.
Left lateral position improves visualization.

Transducer

Phased-array cardiac probe.
Frequency: 2–5 MHz.

Probe Position

Left parasternal border.
2nd–5th intercostal space.

Probe Marker

Directed toward the patient's right shoulder (10 o'clock).

Technique

Place probe beside the sternum.
Adjust depth and gain.
Rotate and angle until LV, LA, MV, AV, LVOT and aortic root are visualized.
Freeze the best image for measurement.

3. Section Structure

Structures Visualized

Right Ventricular Outflow Tract (RVOT)
Interventricular Septum (IVS)
Left Ventricular Cavity (LV)
Left Ventricular Posterior Wall (LVPW)
Mitral Valve
Left Atrium
Aortic Valve
Left Ventricular Outflow Tract
Aortic Root
Ascending Aorta
Pericardium

4. Measuring Method and Normal Values

Posterior–anterior dimensions of the left ventricular cavity, right ventricular cavity, and left atrial cavity can be obtained in this view. The left and right ventricular cavities are measured at the level of the mitral valve chordae during diastole. The normal left ventricular internal diameter is 38 ± 10 mm, while the normal right ventricular internal diameter is 25 ± 10 mm. The left atrial diameter is 33 ± 5 mm, measured at the middle of the left atrium during systole. The aortic valve annulus measures 20 ± 4 mm from the anterior inner edge to the posterior inner edge at the attachment of the aortic valve during systole. The aortic sinus measures 26 ± 8 mm from the anterior inner edge to the posterior inner edge at the level of the sinus of Valsalva during systole. The ascending aorta measures 25 ± 10 mm at a point 2 cm above the aortic sinus during systole. The coronary sinus measures 7 ± 4 mm in the anterior–posterior dimension from the anterior inner edge to the posterior inner edge.

Measurement	Normal Value
IVSd	6–10 mm
LVIDd	Male 42–59 mm Female 39–53 mm
LVIDs	25–40 mm
LVPWd	6–10 mm
Left Atrial Diameter	27–40 mm
Aortic Root Diameter	20–37 mm
Ejection Fraction	55–70%
Fractional Shortening	28–44%

5. Clinical Application

Assessment of LV size.
Evaluation of LV systolic function.
Wall thickness measurement.
Mitral valve assessment.
Aortic valve assessment.
Aortic root measurement.
LVOT evaluation.
Detection of pericardial effusion.
Follow-up of cardiomyopathy.
Assessment of hypertensive heart disease.

6. Diagnosable Pathology

Left Ventricular Hypertrophy (LVH)
Dilated Cardiomyopathy (DCM)
Hypertrophic Cardiomyopathy (HCM)
Left Ventricular Systolic Dysfunction
Regional Wall Motion Abnormality (RWMA)
Mitral Valve Prolapse (MVP)
Mitral Stenosis (MS)
Mitral Regurgitation (MR)
Aortic Stenosis (AS)
Aortic Regurgitation (AR)
Aortic Root Dilatation
Pericardial Effusion
Infective Endocarditis
LVOT Obstruction
Intracardiac Mass or Thrombus

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Saturday, 27 June 2026