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Valvular regurgitation has been traditionally diagnosed by typical auscultatory features. In the past decade, however, echocardiography and cardiac Doppler have been demonstrated to be more sensitive and more specific than the time-honored stethoscope. Properly trained sonographers and physicians must perform color-flow Doppler with careful attention to instrument settings to prevent misdiagnosis. Marry normal individuals have physiologic negurgitation in the absence of a murmur; this has no known clinical significance. Echocardiographic assessment of chamber size and ventricular function, combined with cardiac Doppler, accurately quantifies valvular regurgitation and provides clinically useful information to guide therapy in the majority of patients, eliminating the need for cardiac catheterization.