In chronic ischemic heart disease, Doppler echocardiography (DE) at rest permits semiquantitative evaluation of scarring and remodelling processes, global ventricular function and, frequently, regional wall motion state. Late complications are detected, namely infarct expansion, true and false ventricular aneurysm, mitral insufficiency, thrombus formation, and associated valvular and aortic diseases are discovered. We studied 100 patients with known chronic coronary artery disease referred for noninvasive evaluation, including electrocardiogram (ECG) and DE. In all patients, the global left-ventricular function was satisfactorily assessable. In roughly two thirds of the documented infarctions. DE confirmed the ECG diagnosis and permitted a more precise diagnosis in the majority of them in terms of localization and/or dimension of the necrosis. In one third of the patients. DE clarified inconclusive ECG tracings. Thus, the baseline noninvasive investigation with ECG and DE is a potent tool in the management of chronic ischemic heart disease, serving as a guide to further investigation and to treatment adjustments.