KEY WORDS: Doppler echocardiography, valvular stenoses and insufficiencies, shunts.

ultrasonic examination of the heart ' made the following statement: 'Various forms of ultrasound using the Doppler principle are currently under development for cardiologic applications. While these appear as promising developments they are not widely accepted and cannot be recommended for general use with diagnostic imaging'"1. Since that time the interest in Doppler studies for char-acterizing blood flow in the heart and the great vessels has been increasing and this great interest is reflected by the publication of roughly 500 papers on this subject. Despite this enthusiasm, it appears appropriate to ask several questions concerning the place and merits of Doppler echocardiography in diagnosis, quantification and management of heart disease. Our armamentarium of non- or minimally invasive tests is already large and hence we may ask whether the supplementary information we can get from Doppler echocardio-graphy is really essential in clinical cardiology. Does this new technique really contribute to decision-making or does it solely add to redun-dancy and to overlap of procedures for many common diagnostic problems? With this in mind we shall examine the various areas where Doppler echocardiography has mainly been used. Emphasis will be placed primarily on problems regarding clinical cardiology in adult patients. Valvular stenoses Most Doppler studies which deal with the diagnosis of valvular stenoses have reported excellent sensitivity and specificity. There is n