If you suspect you have heart valve disease, your doctor will perform a physical exam and order a series of tests to confirm a heart valve disease diagnosis. If initial tests indicate a heart valve problem, other tests may be recommended to gather more details about your condition.
During your physical exam, your doctor will ask about your symptoms, your medical history, and your family's health history. Your doctor will also listen to your heart and lungs for heart murmurs or extra heart sounds, examine your feet and legs for swelling caused by excess fluid retention (edema), and review your blood pressure and the rate at which your heart beats (your pulse). Based on initial findings from your physical exam, your doctor will order some diagnostic tests to confirm a preliminary diagnosis of heart valve disease and to continue monitoring and tracking the development of the heart valve problem.
- Echocardiogram (echo, Doppler, or heart ultrasound) – This noninvasive test shows how well your heart is pumping blood, the size and shape of your heart valves and chambers, and if a heart valve has become narrowed or is allowing blood to flow or leak backward.
- Electrocardiogram (ECG or EKG) – This test records the electrical activity in your heart. It can detect abnormalities in your heart's rhythm and certain patterns that suggest portions of the heart may not get enough blood flow.
- Transesophageal echocardiogram (TEE) – Your doctor may recommend a TEE to get a better image of your heart. Medications are given through an IV to put you to sleep as a sound wave wand, positioned on the end of a thin tube, is passed down your throat into your esophagus. The heart structures are then viewed through the thin wall of the esophagus. This is not a painful procedure because you are asleep during the test.
- Chest X-ray – This test can show enlarged sections of your heart, fluid in your lungs, and calcium deposits in your heart. Although it’s not as sophisticated as some other diagnostic technologies, it provides information that cannot be obtained in an examination.
- Stress test – This test shows if you have symptoms of heart valve disease when your heart is working hard, and it helps your doctor assess how severe your disease might be. Stress tests involve exercising or taking medication to make your heart beat fast while images are taken of it.
- Angiogram/cardiac catheterization – After seeing the results from your echocardiogram, your doctor may recommend an angiogram/cardiac catheterization, which can help assess if your symptoms are due to a valve problem or if they relate to a blockage in your artery. Ultimately, catheterization provides detailed information that enables your doctor to develop the best plan for treating your condition.
- Computerized tomographic angiography (CTA) – This test uses X-rays and computers to create detailed images of the blood vessels and the blood flow within them. CTA can be performed to evaluate many of the body’s arterial systems, such as the heart, the brain, or the blood vessels coursing through the chest, abdomen, and pelvis.
- Cardiac magnetic resonance imaging (MRI) – This noninvasive test uses magnetic fields and radio waves to produce 2D or 3D images of blood vessels. These images give doctors a more precise assessment of the severity of the valve leakage and heart chamber size.
It’s important to note that continuous testing is needed for heart valve disease, as the condition tends to progress over time. Even after years of having stable heart valve disease, your condition can suddenly develop into a much more serious issue. You should check with your doctor to determine how often you should have additional testing to monitor your heart valve problems.