Two dimensional echocardiography, because of its wide field of view, has been shown to be superior to the M mode approach for ultrasonic evaluation of the left ventricle. The use of this technique for determination of ventricular volume estimates and detection of asynergy has been promising but is limited by compromised image quality found in many patients with ischemic heart disease. Because it supplies cross-sectional information about the ventricular chamber and wall thickness simultaneously, this new technique lends itself to the anatomic localization of changes in regional performance that accompany ischemic heart disease. It allows simultaneous study of regional dynamic changes in chamber circumference, wall thickness and motion characteristics that give practical information on coronary artery disease and acute myocardial infarction.