Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Principles of Doppler echocardiography

Ayan Patel, MD
Section Editor
Warren J Manning, MD
Deputy Editor
Brian C Downey, MD, FACC


While M-mode and two-dimensional (2D) echocardiography allow for creation of anatomic images of the heart, Doppler echocardiography utilizes ultrasound to record blood flow within the cardiovascular system. Doppler echocardiography is based upon the changes in frequency of the backscatter signal from small moving structures (ie, red blood cells) intercepted by the ultrasound beam.

The principles of Doppler echocardiography will be reviewed here. The principles of other echocardiographic techniques, as well as the normal views and protocol for an echocardiogram, are discussed elsewhere. (See "Echocardiography essentials: Physics and instrumentation" and "Tissue Doppler echocardiography", section on 'Technical aspects' and "Transthoracic echocardiography: Normal cardiac anatomy and tomographic views".)


A moving target will backscatter an ultrasound beam to the transducer so that the frequency observed when the target is moving toward the transducer is higher and the frequency observed when the target is moving away from the transducer is lower than the original transmitter frequency (figure 1). This Doppler phenomenon is familiar to us as the sound of a train whistle as it moves toward (higher frequency) or away (lower frequency) from the observer. This difference in frequency between the transmitted frequency (F[t]) and received frequency (F[r]) is the Doppler shift:

Doppler shift (F[d])  =  F[r]  -  F[t]

Blood flow velocity (V) is related to the Doppler shift by the speed of sound in blood (C) and ø, the intercept angle between the ultrasound beam and the direction of blood flow. A factor of 2 is used to correct for the "round-trip" transit time to and from the transducer.

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:

Subscribers log in here

Literature review current through: Nov 2017. | This topic last updated: Mar 31, 2017.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.