What view should be examined if an anechoic dropout of the interatrial septum is seen?

When an anechoic dropout of the interatrial septum is observed on an echocardiogram, the subcostal 4-chamber view is particularly useful for further examination. This view allows for a detailed assessment of the interatrial septum because it provides a clear angle to visualize the structure from the inferior aspect, which is critical for identifying any potential defects or abnormalities, such as atrial septal defects or other forms of septal malformations.

In the subcostal view, the interatrial septum is well visualized, enabling the sonographer to evaluate the integrity and morphology of the septum, especially if there is a concern about anechoic areas suggesting a defect or fluid collection. This orientation helps in obtaining relevant measurements and enhances the assessment of the atrial chambers as well.

Choosing the subcostal 4-chamber view for this purpose is beneficial because it minimizes interference from lung tissue and ribs, which can obscure the imaging of cardiac structures. Other views, such as the parasternal long axis, aortic short axis, or apical 2-chamber view, do not provide the same level of direct access and visualization of the interatrial septum, making them less ideal for this specific inquiry