Two-dimensional Doppler echocardiography--window into the heart

The interfacing of two-dimensional and Doppler ultrasound of the heart in a single piece of equipment is a technological development that may change the way in which cardiac conditions are diagnosed and monitored. The device's two-dimensional capabilities create images of the heart at virtually the same time that its Doppler capabilities are providing information on the blood flowing through the heart. As a complete assessment of cardiac disease requires information on both the heart's structure and its function, two-dimensional Doppler ultrasound enables a fairly comprehensive view of a cardiac condition to be achieved with one noninvasive and relatively inexpensive procedure. While cardiac catheterization may as yet be more efficacious, there are many instances--such as in the emergency department or coronary care unit--in which examination by two-dimensional Doppler echocardiography may provide sufficient information to be the modality of choice. While neither its optimal location in the hospital nor its appropriate departmental sponsorship will be easily decided, two-dimensional Doppler ultrasound is clearly a technology that warrants investment by hospitals with substantial numbers of cardiac patients. This assessment examines the new roles created for echocardiography by recent technological developments, and provides hospital decisionmakers with insights into many of the complex issues involved in acquiring two-dimensional Doppler echocardiography services.