Heart Valve Diseases Diagnosis

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To diagnose a heart valve disease, your healthcare provider may review your medical history, do a physical exam, and order tests to check the shape of your heart and how well it works.

Your doctor will ask about your risk factors, your symptoms, and any related heart valve conditions that run in your family.

During a physical exam, your doctor may do the following:

• Listen to your heart with a stethoscope for the sounds of a heart murmur or irregular rhythm.
• Feel the strength of your pulse on your neck or arm.
• Examine a newborn’s abdomen for signs of a liver that is larger than normal.

The echocardiogram is the most common test to diagnose a problem with the heart valves.

Echocardiography, or echo, is a painless test that uses sound waves to create moving pictures of your heart. The pictures show the size and shape of your heart and how well your heart is pumping blood. A type of echo called Doppler ultrasound shows how well blood flows through your heart's chambers and valves.

Echo can detect blood clots inside your heart, fluid buildup in the pericardium (the sac around the heart), tumors, and problems with the aorta. The aorta is the main artery that carries oxygen-rich blood from your heart to your body. Echo also can help your doctor find the cause of abnormal heart sounds, such as heart murmurs. Your doctor also might use echo to see how well your heart responds to certain heart treatments.

To diagnose heart valve disease, your doctor may do other tests in addition to echocardiography.

Electrocardiogram

An electrocardiogram, also called an ECG or EKG, is a simple, painless test that detects and records your heart’s electrical activity. An EKG can show how fast your heart is beating, whether the rhythm of your heartbeats is steady or irregular, and the strength and timing of the electrical impulses passing through each part of your heart. You may have an EKG as part of a routine exam to screen for heart disease.

An EKG may be recorded in a doctor’s office, an outpatient facility, in a hospital before major surgery, or as part of stress testing. For the test, you will lie still on a table. A nurse or technician will attach up to 12 electrodes to the skin on your chest, arms, and legs. Your skin may need to be shaved to help the electrodes stick. The electrodes are connected by wires to a machine that records your heart’s electrical activity on graph paper or on a computer. After the test, the electrodes will be removed.

An EKG has no serious risks. EKGs don’t give off electrical charges such as shocks. You may develop a slight rash where the electrodes were attached to your skin. This rash usually goes away on its own without treatment.

Chest X-ray

A chest X-ray is a fast and painless imaging test to look at the structures in and around your chest. 

This test can help diagnose and check conditions such as pneumonia, heart failure, lung cancer, tuberculosis, sarcoidosis, and lung tissue scarring, called fibrosis. Doctors may use chest X-rays to see how well certain treatments are working and to check for complications after certain procedures or surgeries. 

The test may be done in the doctor’s office, clinic, or hospital. You will stand, sit, or lie still for the test.

Chest X-rays have few risks. The amount of radiation used in a chest X-ray is very small. Talk to your provider if you are or could be pregnant.

Stress test

A stress test measures how healthy your heart is and how well it works during physical stress. Some heart problems are easier to identify when your heart is working hard to pump blood throughout your body, such as when you exercise.

Your doctor may recommend this test if you have symptoms of a heart problem, such as shortness of breath, chest pain, dizziness, and a rapid or irregular heartbeat. If your doctor does find a problem, the stress test also can help your doctor choose the right treatment plan and determine what types of physical activity are safe for you.

You may do a stress test in your doctor’s office or a hospital. The test usually involves physical exercise such as walking on a treadmill or riding a stationary bicycle. If you are not able to exercise, your doctor will give you medicine that will make your heart work hard and beat faster, as if you were exercising. Your doctor may ask you not to take some of your prescription medicines or to avoid coffee, tea, or any drinks with caffeine on the day of your test, because these may affect your results. Your doctor will ask you to wear comfortable clothes and shoes for the test.

For the stress test, your doctor will put sticky patches called electrodes on your chest and attach a blood pressure cuff to your arm and a pulse monitor to your finger or other part of your body. Your doctor will measure your heart activity and blood pressure before you start the test.

You will slowly start to exercise on a treadmill or stationary bicycle, and then gradually increase the treadmill speed or bicycle resistance until your heart is working at the target heart rate for your age. Most often, a stress test includes an electrocardiogram to measure your heart’s electrical activity as you exercise. Your doctor may also measure your blood oxygen level, blood pressure, and heart rate. During the test, you will exercise for 10 to 15 minutes. Your doctor will stop the test if you show any sign of a heart problem, or if you are too tired to continue the test. If you are not able to exercise, your doctor will give you medicine over a 10- to 20-minute period through an intravenous (IV) line into one of your blood vessels.

After the stress test, your doctor will measure your heart activity and blood pressure to make sure that both measurements are back within the normal range. You should be able to return to your normal activities right away.

Your doctor may suggest screening tests if you have known risk factors for a heart valve disease or as part of a routine visit. Finding heart valve diseases early can lead to treatments that may prevent or fix problems. Several screening tests can identify heart valve disease.

• Prenatal screening is used during pregnancy to check a developing baby’s heart.
• Newborn screening tests are recommended for all newborns in the United States. One of the most common heart screening tests for newborns uses pulse oximetry to measure how much oxygen is in the baby’s blood. Low blood oxygen levels may be a symptom of dangerous heart defects. This test involves attaching sensors to the baby’s hands and feet to measure oxygen levels. Low blood oxygen levels might alert doctors to a blocked valve or valve that is not working.
• Screening after cancer treatment is important because you may have a higher risk of developing heart valve diseases after radiation treatments.