5. Suprasternal View of the Aortic Arch

Step 4. Obtain a Longitudinal View of the Thoracic Aorta.

  • This view will show the ascending aorta, the aortic arch with its 3 main branches, and the descending aorta. You may see a transverse view of the right pulmonary artery (RPA) as well.
Suprasternal Notch View Ultrasound
Suprasternal notch view. Seen here are the right pulmonary artery (RPA) in cross-section, plus the aortic arch and its 3 main branches: the brachiocephalic, left common carotid, and left subclavian artery.

Use color Doppler to assess flow in the thoracic aorta.

  • You should see red color Doppler flow (towards probe) in the ascending aorta and blue color Doppler flow (away from probe) in the descending aorta.
Suprasternal Notch View Ultrasound Color Doppler
Suprasternal View with Color Doppler
5. Suprasternal View of the Aortic Arch

Step 3. Position your Probe in the Suprasternal Notch.

  • Place the indicator towards the patient’s head.
  • Rock the tail of the probe superiorly.
  • Then, rotate slightly clockwise (15-20˚) towards the patient’s left shoulder. This allows the ultrasound window to align with the trajectory of the thoracic aorta, which crosses from right-to-left as it arches posteriorly.
Suprasternal Notch View Ultrasound Probe Position
Suprasternal Notch View Ultrasound Probe Position
5. Suprasternal View of the Aortic Arch

Suprasternal View of the Aortic Arch

The ultrasound Suprasternal Notch View offers a long-axis view of the thoracic aorta including the ascending aorta, the 3 main branches of the aortic arch (the brachiocephalic trunk, left common carotid artery, and left subclavian), and the descending aorta. This view is especially useful when evaluating for a thoracic aortic aneurysm or Type A aortic dissection.

Step 1: Select your Probe.

  • Use a Phased Array probe in Cardiac mode. The small footprint of the Phased Array probe allows you to go through the small space of the sternal notch.

Step 2: Position your Patient.

  • Your patient should be supine with their neck extended (see below).
  • *Placing a pillow under the patient’s shoulders can be helpful.