How does one obtain ideal echo images for a person who has congenital heart disease and unusual anatomy?

My husband has shifting of his heart to the right side congenitally missing a rib on right and 1 extra rib on left. He’s in his 50s, little overweight by 25 lbs. Echo is hard to get good image. Any suggestions?

Submitted by Lisa from New York on 01/21/2016

In the situation indicated, sometimes the sonographer can get improved images by rolling the patient to the right side instead of the usual left side, and use respiratory maneuvers that most sonographers know. There is a small percentage of patients that have no optimal surface images because of heart, lung & skeletal relationships.