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A system for automatically determining the contour of the left ventricle (LV) and its bounded area, from transesophageal echocardiographic (TEE) images is presented. It uses knowledge of both heart anatomy and echocardiographic imaging to guide the selection of image processing methodologies for thresholding, edge detection, and contour following and the center-based boundary-finding technique to extract the contour of the LV region. To speed up the processing a rectangular region of interest from a TEE picture is first isolated and then reduced to a coarse version, one-ninth original size. All processing steps, except the final contour edge extraction, are performed on this reduced image. New methods developed for automatic threshold selection, region segmentation, noise removal, and region center determination are described.