April 1, 2022

How heart valve problems are diagnosed

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There are several imaging tests to check for heart valve problems and pinpoint what’s happening.

If your doctor suspects that one or more of the four valves in your heart is not working correctly, you’ll need some tests to determine which valve is having a problem.

To diagnose a damaged or diseased heart valve, your doctor will first ask you about your family history and your medical history. After that, you may need an ultrasound of your heart (an echocardiogram) and other imaging tests for heart disease. These procedures to check heart valves help diagnose your heart valve problem and rule out any other disease you may have.

Listening to your heart

A problem with a heart valve will usually cause the heart to make a noise. This noise is typically from turbulence of blood flow as it passes through the valve. Your provider can hear this noise, called a murmur, with a stethoscope. But you can have a heart murmur and not have valve disease or any other heart problem. Other heart valve tests can help confirm the diagnosis of valve disease. Heart murmurs are most often completely normal. But sometimes they can be a sign of heart disease.

Looking at your heart

A transthoracic echocardiogram (also called a surface echocardiogram), or echo, is an ultrasound of the heart. Ultrasound creates images with sound waves. This test is called transthoracic because the images are taken from the surface of the chest wall, outside your body. A transthoracic echocardiogram is sometimes called by its abbreviation, TTE. It’s a simple, painless procedure to check heart valves that bounces harmless sound waves off the heart. These sound waves become images on a video screen. Your provider can then see a moving picture of your heart. This test shows how the valves work. It can confirm whether a valve is narrowed or leaking. It can also show the size of the heart’s chambers and whether your heart muscle pumps normally. 

A special type of echo, called a transesophageal echo (TEE), may be done as well. This heart valve test can provide even more detailed information about your heart valves. But a TEE is somewhat more involved than a surface echo. It requires a probe to be passed into the tube leading from your mouth to your stomach (the esophagus). So a surface echo is often the first test done. Echo testing can help your provider watch changes in your heart over time.

Other heart valve tests

Your doctor may order a chest X-ray for another look at your heart and lungs. You may have an electrocardiogram, a test that shows the rhythm of the heartbeat. You may have cardiac catheterization, an invasive test, to look inside the heart. This test helps measure the pressure in the chambers, checks for leaky valves, and looks for problems in the heart’s arteries. A cardiac MRI can also be done to evaluate the heart tissue including valves.

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Vanderbilt University Medical Center is a leader in treating heart valve disease with the newest transcatheter techniques. Vanderbilt’s team includes general cardiologists, interventional cardiologists and cardiac surgeons, all with advanced training and expertise in structural heart and valve disease. They treat patients with diseases of the aortic, mitral or tricuspid valve, from the routine to the complex.

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