Flow Doppler imaging has become an integral part of an echocardiographic exam. Automated interpretation of flow doppler imaging has so far been restricted to obtaining hemodynamic information from velocity-time profiles depicted in these images. In this paper we exploit the shape patterns in Doppler images to infer the similarity in valvular disease labels for purposes of automated clinical decision support. Specifically, we model the similarity in appearance of Doppler images from the same disease class as a constrained non-rigid translation transform of the velocity envelopes embedded in these images. The shape similarity between two Doppler images is then judged by recovering the alignment transform using a variant of dynamic shape warping. Results of similarity retrieval of doppler images for cardiac decision support on a large database of images are presented. ©2010 IEEE.