How Is Heart Valve Disease Diagnosed?

Your primary care provider may detect a heart murmur or other signs of heart valve disease. However, a cardiologist will usually diagnose the condition. A cardiologist is a doctor who specializes in treating heart problems.

To diagnose heart valve disease, your doctor will ask about your symptoms. (See "What Are the Signs and Symptoms of Heart Valve Disease?")

He or she also will do a physical exam and look at the results of medical tests and imaging.

Physical Exam

Your doctor will listen to your heart with a stethoscope to find out if you have a heart murmur that's likely caused by a heart valve problem.

Your doctor also will listen to your lungs as you breathe to check for fluid buildup. He or she will check for swollen ankles and other signs that your body is keeping in water.

Tests and Procedures

The main test for diagnosing heart valve disease is echocardiography. But an EKG (electrocardiogram) or chest x ray is commonly used to reveal certain signs of the condition. If these signs are present, echocardiography usually is done to confirm the diagnosis.

Your doctor also may have you undergo other tests, such as cardiac catheterization, stress testing, or cardiac MRI (magnetic resonance imaging), if you're diagnosed with heart valve disease. These tests and procedures can help your doctor better assess how severe your condition is and plan treatment.

Electrocardiogram

This is a simple test that detects and records the electrical activity of your heart. It can detect an irregular heartbeat and signs of a previous heart attack. It can also show whether certain chambers of your heart are enlarged.

An EKG usually is done in your doctor's office.

Chest X Ray

This test can show whether certain sections of your heart are enlarged, whether you have fluid in your lungs, or whether there are calcium deposits in your heart.

This test helps your doctor learn which type of valve defect you have, how severe it is, and whether you have any other heart problems.

Echocardiography

The test uses sound waves to create a moving picture of your heart as it beats. A wand that's placed on the surface of your chest transmits the sound waves. Echoes from the sound waves are converted into pictures of your heart on a computer screen.

An echocardiogram can show:

• The size and shape of your heart valves and chambers
• How well your heart is pumping blood
• Whether a valve is narrowed or has backflow

Your doctor may recommend a transesophageal (tranz-ih-sof-uh-JEE-ul) echocardiogram, or TEE, to get a better image.

For a TEE, the sound wave wand is put on the end of a special tube. The tube is passed down your throat and into your esophagus (the tube leading from your mouth to your stomach). You will be given medicine to relax you during this procedure.

Cardiac Catheterization

For this procedure, a long, thin, flexible tube called a catheter is put into a blood vessel in your arm, upper thigh (groin), or neck and threaded into your heart. Your doctor uses x-ray images to guide the catheter.

Through the catheter, your doctor does diagnostic tests and imaging that show whether backflow is occurring through a valve and how fully the valve opens. You're given medicine to help you relax, but you're awake during the procedure.

Your doctor may order a cardiac catheterization if your signs and symptoms of heart valve disease aren't in line with your echocardiography results. The procedure also can help your doctor assess whether your symptoms are due to specific valve problems or coronary artery disease. All of this information helps your doctor decide the best way to treat you.

Stress Test

During stress testing, you exercise to make your heart work hard and beat fast while heart tests and imaging are done. If you can't exercise, you'll be given medicine to make your heart work hard and beat fast.

A stress test can show whether you have signs and symptoms of heart valve disease when your heart is working hard. It can help your doctor assess the severity of your heart valve disease.

Cardiac MRI

Cardiac MRI uses a powerful magnet and radio waves to make detailed images of your heart. A cardiac MRI image can confirm information about valve defects or provide more detailed information.

This information can help your doctor plan your treatment. An MRI also may be done before heart valve surgery to help your surgeon plan for the surgery.