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Doppler echocardiography: theory, instrumentation, technique, and application.

A Doppler examination is a valuable adjunct to a complete echocardiographic examination. It has the capability of measuring normal and abnormal velocities of blood flow noninvasively. For the first time, this procedure allows noninvasive quantitation of stenotic gradients, intracardiac pressures, and blood flow as well as semiquantitative assessment of regurgitant lesions. With this procedure, the operator must progress through a learning curve in order to gain a complete understanding of the examination techniques, the limitations of the instruments, and the Doppler physics principles before applications can be made to clinical practice. Evaluation of other aspects of Doppler echocardiography, such as color-flow mapping and assessment of diastolic events, portends great promise for the role of this procedure in the future.

Adult↗

Diagnosis and assessment of valve stenosis and regurgitation and coarctation of the aorta with Doppler ultrasound.

With the use of Doppler ultrasound localized increases in blood flow velocities can be recorded and used to diagnose obstructions to blood flow. From the increase in maximal velocities the pressure drop across an obstruction can be calculated, both the peak instantaneous and the mean pressure drop. Regurgitations are diagnosed by recording reversal of blood flow across the valve. Semi-quantitative evaluation of the degree of regurgitation can be made by using both jet width, extension and intensity, as well as increase in forward flow velocity, reversal of flow in great vessels and influence on pressures. In coarctation of the aorta localized increase in velocity in the descending aorta can be shown and the pressure drop can be calculated. In some, more than one level of obstruction can be shown. In neonates the presence of a patent ductus arteriosus may mask the obstruction and a significant pressure drop may become apparent only when narrowing or closure of the duct occurs.

Aortic Coarctation↗

A case of congenital triple valve disease.

We report a case of congenital triple valve stenosis with dominant pulmonary valve disease, sparing the aortic valve, presenting at the age of 51 years with progressive shortness of breath and central cyanosis. At post mortem, no intracardiac right to left communication could be demonstrated.

Female↗