Colour-coded doppler echocardiography uses a pulsed doppler shooting lines scanning system to perform a true real-time doppler angiography of intracradiac flows. Combined with ultrasonic imaging, it has proved irreplaceable for the diagnosis of leakages and for direct visualization of intracradiac shunts; by determining the anatomical location of the jet it facilitates an accurate pulsed and continuous Doppler study. Aortic leakages are best evaluated by measuring the jet at its point of origin. The quantification of moderate to medium leakages remains difficult since it depends on numerous factors and needs integration of other echocardiographic data. Echocardiographic contrast tests after intravenous injection of microbubbles diagnose the right-to-left shunts by the passage of contrast into the left cavities, and the left-to-right shunts by a washing image.