What is the best ultrasound probe to use for point-of-care cardiac ultrasound: phased-array probe, curvilinear probe, or linear probe?

Best Ultrasound Probe for Point-of-Care Cardiac Ultrasound

The phased-array probe is the optimal transducer for point-of-care cardiac ultrasound. 1

Primary Recommendation

The phased-array cardiac transducer is specifically designed for cardiac imaging and should be your first choice for all point-of-care cardiac ultrasound examinations. 1 This probe type offers critical advantages that directly impact your ability to obtain diagnostic-quality cardiac images:

Why Phased-Array is Superior

• Narrow intercostal window access: The phased-array probe's small footprint facilitates scanning through the narrow intercostal spaces, which is essential for obtaining parasternal and apical cardiac windows. 1

• High frame rates: This probe type is capable of high frame rates that provide superior resolution of rapidly moving cardiac structures, which is critical for assessing ventricular function and valve motion. 1

• Standard cardiac views: All standard cardiac imaging views (parasternal long-axis, parasternal short-axis, apical four-chamber, and subcostal four-chamber) are obtained using a phased-array probe as the reference standard. 1

• Optimal image quality criteria: Expert consensus defines ideal cardiac ultrasound images as those obtained with a phased-array transducer in cardiac preset mode. 1

Alternative When Phased-Array is Unavailable

If a phased-array probe is not available, a 2-5 MHz general-purpose curved array (curvilinear) abdominal probe with a small footprint will suffice as a backup option. 1

Curvilinear Probe Considerations

• The curvilinear probe can provide adequate cardiac images when a phased-array is unavailable, though it is suboptimal. 1

• For abdominal aorta evaluation specifically, 2.5-5 MHz curvilinear array transducers provide optimal visualization, and phased-array probes used for echocardiography may give sufficient image quality in many patients for this particular application. 1

• The wider footprint of curvilinear probes makes intercostal window access more challenging compared to phased-array probes. 1

Linear Probe: Not Recommended

Linear probes are not appropriate for point-of-care cardiac ultrasound. Linear high-frequency probes lack the necessary depth penetration and field of view required for cardiac imaging, and they cannot adequately fit between intercostal spaces for standard cardiac windows.

Clinical Application Algorithm

When performing point-of-care cardiac ultrasound:

1. Select phased-array probe (2-5 MHz frequency range) as your primary transducer. 1

2. Activate cardiac presets on your ultrasound machine to optimize cardiac images. 1

3. Obtain all four standard views: parasternal long-axis, parasternal short-axis, apical four-chamber, and subcostal four-chamber. 1

4. Only if phased-array unavailable: Use a small-footprint curvilinear probe (2-5 MHz) as your backup option. 1

Common Pitfalls to Avoid

• Do not attempt cardiac imaging with linear probes: These high-frequency transducers lack adequate penetration depth and appropriate field of view for cardiac structures.

• Ensure proper probe orientation: Place the indicator on screen in a location consistent with local or specialty convention to avoid misinterpretation. 1

• Optimize depth and gain settings: Adjust these parameters to ensure clear definition of endocardial borders and cardiac structure morphology. 1

• Recognize off-axis views: Learn to identify and correct oblique or off-axis views that can lead to misinterpretation of cardiac function and pathology. 1