In this study, we investigate how the recently introduced high efficiency video coding (HEVC) standard can be used in the design of reproducible medical ultrasound video diagnosis systems. We introduce a set of clinical criteria that are used to validate the clinical capacity of HEVC encoded atherosclerotic plaque ultrasound videos. The clinical criteria include the assessment of atherosclerotic plaque geometry, morphology, and motion. The efficiency of HEVC compared to prior video coding standards is then demonstrated based on the use of objective ratings. Ultimately, the goal is to support diagnostically lossless compression at the clinically acquired video resolution and frame rates for storage, streaming, and follow-up visualization.