This review is directed at the clinically useful highlights of ultrasound and radionuclide testing in adults with coronary and valvular heart disease, intracardiac shunts, and hypertrophic and congestive cardiomyopathies. As a clinical toto, the radionuclide procedures are currently more useful than ultrasound examination in evaluating patients with known or suspected coronary artery disease. This includes both primary diagnosis and the more accurate estimation of left ventricular function in the presence of segmental asynergy. In patients with valvular disease, the radionuclide procedures are only indirectly useful, while the ultrasound examination is more often diagnostic. These two techniques are complimentary to one another in their ability to noninvasively evaluate and monitor both chamber size and ventricular function in virtually all patients. Recent research involving noninvasive ventricular imaging during physiologic and pharmacologic intervention holds promise for a more sophisticated noninvasive approach to patient management.