Echocardiography provides important information for physicians in diagnosing heart disease. Due to issues of cost, personnel, and availability of qualified individuals, echocardiography has not been used to its full potential, especially in rural areas. Telemedicine applications linking physicians to underserved areas are increasing in number, especially in the area of radiology. Real-time echocardiography is limited in the number of telemedicine rural sites. A store-and-forward system collects electronic information and stores it on a telemedicine system for viewing by a physician at a later date. This method of consultation of echocardiograms has been studied previously. However, the equipment used was not adequately integrated or interchangeable with other diagnostic equipment and was very labor-intensive for the purpose of their study. Echocardiograms have also been transmitted over regular telephone lines at 14 kbs. However, this resulted in large file transfers and required the technician to choose the selected segments to be studied by the consulting physician.4 With the availability of web-based systems, physicians who do not have access to a pediatric cardiologist could use a low-cost web-based tool for consultation.