How is valve disease diagnosed?

Your doctor will talk to you about your symptoms and medical history; then perform an exam and diagnostic tests. Those results will help the doctor make a diagnosis.

The physical exam may show that you have fluid in your lungs, an enlarged heart, or a heart murmur. A heart murmur is the sound made by blood moving through a narrowed or a leaky valve.

Diagnostic tests help determine the location, type and extent of your valve disease. They help your doctor see how severe the leak or stenosis is and how it is affecting your heart's function and ability to pump blood. These tests may include:

  • Electrocardiogram (EKG or ECG): A picture on graph paper of the electrical impulses traveling through the heart muscle. Electrodes (small, sticky patches) are placed on the body, and they send the information that creates the picture. an EKG can detect abnormal electrical activity in the heart.
  • Cardiac catheterization (cardiac cath or coronary angiogram): An invasive imaging procedure sued to check heart function. During a cardiac catheterization, a long, narrow tube (catheter) is guided through a blood vessel in the arm or leg to the heart with the help of a special X-ray machine. Contrast dye is injected through the catheter, and X-ray movies are created as the dye moves through the heart. A cardiac cath can detect a narrowed or insufficient valve, as well as looks at your coronary arteries and heart chambers.
  • Magnetic resonance imaging (MRI): A large magnet and radio waves are used to produce a picture of the heart's valves and chambers. It can create moving images of the heart as it is pumping and can detect abnormal blood flow through the heart.
  • Echocardiogram (echo): A graphic outline of the heart's movement. High frequency sound waves are sent through a transducer wand that is placed on your chest. This produces pictures of the heart's valves, chambers and pumping action of the heart. An echo can show a narrowed or insufficient valve.

Specialized echos include:

  • Doppler ultrasound and color Doppler: Doppler is often combined with echo to detect changes in the blood flow across the heart valves and pressures within the chambers.
  • Exercise stress echocardiogram: an echo performed while you exercise to see how your heart works when you are active.
  • Transesophageal echocardiogram (transesophageal echo or TEE) - 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 lets your doctor get a closer look at the valves, the heart chambers and the back of the heart.
  • Myocardial strain imaging: Used to check for changes in heart function
  • 3D echo: This echo can display parts of your heart in 3 dimensions so your doctor can more completely measure the size and check the function of your heart and valves.

Your doctor may order other tests not listed here to get more detailed information about your medical condition and heart function. You will receive detailed information about the testing you need, including how to prepare and what to expect. If you have questions at any time about testing, please ask your doctor or other members of your healthcare team.

By repeating these tests over time, your doctor can see the progress of your valve disease and help you make decisions about your treatment.

Last reviewed by a Cleveland Clinic medical professional on 04/29/2019.

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