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Examples of right ventricular fractional area change (FAC). Percentage FAC = 100 x end-diastolic area (AreaED) - endsystolic area (Area ES)/end-diastolic area. The endocardial border is traced in apical 4-chamber (A4C) views from the tricuspid annulus along the free wall to the apex, then back to the annulus, along the interventricular septum at end-diastole (ED) and end-systole (ES). Trabeculation, tricuspid leaflets, and chords are included in the chamber. (Left) Normal subject, FAC 60%. (Middle) Moderately dilated right ventricle (RV), FAC 40%, and a markedly dilated left ventricle (LV). (Right) Dilated RV, FAC 20%, and the LV is foreshortened as a result of optimizing the view for the right ventricular chamber.