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In 35 patients with aortic stenosis the Doppler-derived values of the aortic valve area (continuity equation) were compared with those determined at cardiac catheterization (Gorlin’s formula). The comparison of three modifications of the continuity equation showed that the procedure generally proposed (calculating the area of the left ventricular outflow tract from its diameter) significantly underestimated the valve area (modification 1). Modification 2, which used direct planimetry of the left ventricular outflow tract, yielded results quite consistent with invasive measurements. The employment of peak velocities instead of velocity-time integrals (modification 3) did not significantly alter the results. However, the scatter was considerable in all three modifications. When critical aortic stenosis was defined with a valve area ≤ 0.70 cm², modifications 1, 2, and 3 accurately predicted the severity of stenosis in 80, 86, and 80%, respectively.

Patients with TTC display clinical symptoms and electrocardiographic findings that mimic acute myocardial infarction. A history of a preceding stressful event in elderly women, typical echocardiographic findings of TTC, and only a mild elevation of cardiac markers will be informative. Acute-coronary angiography should be performed in order to rule out acute coronary occlusion and to avoid inadequate treatment such as thrombolysis.

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In 60 patients with aortic regurgitation, angiography and cross-sectional Doppler echocardiography have been compared in order to examine the reliability of the noninvasive method in quantitating aortic regurgitation. In a parasternal short-axis view just below the aortic valve, the ratio of the cross-sectional area of the jet divided by the cross-sectional area of the left ventricular outflow tract was determined. This measurement was possible in 50 patients (83%). Grossman's classification was used as the criterion for assessing the severity of aortic regurgitation by angiography. Values for the ratio of grade I ranged from 0.03 to 0.18, II 0.06 to 0.29, III 0.30 to 0.55, and IV 0.40 to 0.65. Assuming four Doppler grades (less than 0.15, 0.15-0.29, 0.30-0.44, greater than or equal to 0.45), we found complete agreement between the two methods in 42 patients (84%). In six cases there was underestimation, in two cases overestimation, by one grade only. Considering all cases, X2 analysis gave 96.6, P less than 0.00001, the contingency coefficient was 0.81. We conclude that, using this measurement, cross-sectional Doppler is a reliable method for the quantitative evaluation of aortic regurgitation.