Once normal flow patterns are understood, the next step is to determine whether any abnormalities are present.

Questions to ask when evaluating a Doppler spectrum for abnormalities:

• Which method was used to record the flow information: pulsed wave or continuous wave Doppler?
• What transducer position was used?
• Where within the heart was the sample volume (pulsed wave Doppler) or the ultrasound beam (continuous wave Doppler) positioned?
• From this sampling location, in which direction should blood be flowing? ·
• In which portion(s) of the cardiac cycle should normal flow occur from this sampling location?
• Are increased velocities measured?
• In which portion(s) of the cardiac cycle?
• If a velocity measurement was made, was a thorough interrogation of the area performed in an attempt to orient the beam most parallel to flow?
• Was spectral broadening detected? In which portion of the cardiac cycle?
• If a flow disturbance was detected, what was its origin?