In 56 patients with ischaemic heart disease the authors evaluated the blood flow in the pulmonary veins, using transoesophageal echocardiography by the pulsed Doppler technique in the left upper pulmonary vein. They assessed the peak systolic velocity (pVS), the systolic integral time-velocity (S-VTI), the peak diastolic velocity (pVD) and the integral time velocity in the diastolic part of the flow (D-VTI). They found a statistically significant correlation between the ratio pVS/pVD and the LVEDP assessed by the invasive method (r = 0.812). In 36 patients the authors evaluated the flow rate and time-velocity integral at rest and after administration of 0.78 mg/kg dipyridamol by the i.v. route. In 17 patients with affections of 2 or 3 coronary arteries (group A) after the administration of dipyridamol an increase of the maximal flow rate occurred in the diastolic portion of the flow (at rest 54.7 +/- 12.5, after dipyridamol 64.9 +/- 14.8 cm/s). The systolic flow velocities did not change in this group of patients (at rest 52.2 +/- 3.0, after dipyridamol 54.3 +/- 14.0 cm/s). In 19 patients with a negative coronarographic finding (group B) or with stenosis of one coronary artery after dipyridamol administration the systolic peak velocity increased (from 58.0 +/- 10 to 70.2 +/- 14.8 cm/s). The pVD values increased slightly after dipyridamol (at rest 42.5 +/- 14.3, after dipyridamol 52.1 +/- 15.6 cm/s).(ABSTRACT TRUNCATED AT 250 WORDS)