Your cardiologist (heart doctor) will diagnose valve disease after:
Talking to you about your symptoms and medical history
Performing a physical exam. A physical examination may reveal fluid in the lungs, an enlarged heart, or a heart murmur, which is the sound made by blood moving through a stenotic or a leaky valve.
- Performing diagnostic tests.
These tests help your cardiologist evaluate the extent of your valve disease, its effect on the function of your heart, and the best form of treatment for you. Tests may include:
- Echocardiogram (echo) - An "echo" is a graphic outline of the heart's movement. A sound-wave transducer wand is placed on the surface of the chest. High frequency sound-waves are used to provide pictures of the heart's valves and chambers and to look at the pumping action of the heart. Echo is often combined with Doppler ultrasound and color Doppler to detect changes in the blood flow across the heart valves and pressures within the chambers. An echocardiogram can be performed at rest or during exercise.
- Transesophageal echocardiogram (transesophageal echo or TEE) - TEE is similar to a Doppler echo. During a TEE, a sound-wave transducer is placed on the end of a special tube (called an endoscope) and passed into the mouth and down the esophagus (food pipe). This allows doctors to get a closer look at the valves, the heart chambers and the back of the heart.
- Cardiac catheterization (cardiac cath or angiogram) - A catheter (inserted into your arm or leg) is guided to your heart, contrast dye is injected and x-ray movies of you coronary arteries, heart chambers, and heart valves are taken.
- Electrocardiogram (EKG or ECG) - The electrical activity of the heart is recorded on graph paper, using small electrode patches attached to the skin that transmit information to a computer.
Additional tests, such as the exercise stress echocardiogram, radionuclide scans, and magnetic resonance imaging (MRI) may also be used.
By repeating these tests over time, your doctor can see the progress of your valve disease and help you make decisions about your treatment.
The physical exam: the first step in diagnosing valve disease
During a physical exam, your doctor will listen to your heart to hear the sounds the heart makes as the valves open and close.
A murmur is a swishing sound made by blood flowing through a stenotic or leaky valve. Your doctor can also tell if your heart is enlarged or if your heart rhythm is irregular.
The doctor will listen to your lungs to hear if you are retaining fluid in your lungs, which shows your heart is not able to pump as well as it should.
By examining your body, the doctor can find clues about your circulation and the function of your other organs.