In a one-year period, 33 infants with a systolic cardiac murmur were examined by Doppler-echocardiography. The clinical diagnosis based on ECG, X-ray and physical examination by a pediatrician or cardiologist was changed or established by Doppler-echocardiographic examination in 63% of the cases. In almost all cases, this meant changing of the strategy concerning further diagnostic evaluation and therapy. In eight (24%) of the infants no malformation was detected by Doppler-echocardiography, and no further cardiological examinations were carried out. In eight (24%) infants a complex heart malformation was detected. Three of these infants had no clinical signs of heart disease except for the murmur. Because an early and accurate diagnosis is important in the management of infants with heart disease, we recommend that infants suspected of having congenital heart disease are examined by Doppler-echocardiography in a department with experience in this technique.