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Paper Chase

Assessment of valvular heart disease with Doppler echocardiography.

JAMA. Oct 20, 1989;262(15):2131-5.
Lee RT, Bhatia SJ, St John Sutton MG.

Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.


The addition of Doppler principles to two-dimensional echocardiography has revolutionized the noninvasive evaluation of valvular heart disease. Doppler techniques allow precise measurements of blood flow velocity at different locations in the heart and great vessels, so that many aspects of hemodynamics can now be measured noninvasively. These techniques are particularly useful for the quantitative assessment of valvular stenosis; both valve areas and transvalvular gradients may be determined. Doppler echocardiography (particularly with color flow mapping) is also useful for the qualitative assessment of valvular regurgitation. By understanding the uses and limitations of Doppler echocardiography, physicians may now confidently follow up patients with mild or moderate valvular disease with serial noninvasive studies, avoiding the risks of cardiac catheterization in many patients.