Aortic Valve Disease

Diagnosis

At Mayo Clinic, diagnosis begins with a complete physical examination by a medical team that specializes in heart care. Patients will be asked about their general health, including signs and symptoms, and a history of heart disease in their family.

Various tests can help diagnose the type of heart valve problem, the possible cause of a heart valve defect, determine how serious the problem is and whether the aortic valve needs to be surgically repaired or replaced. Diagnostic tests may include:

Chest X-ray

An X-ray image of the chest allows the physician to study the size and shape of the heart and determine whether the heart's left ventricle (lower left chamber) is enlarged — a possible sign of a damaged aortic valve. A chest X-ray can also reveal calcium deposits on the aortic valve. In addition, a chest X-ray helps the physician check the condition of the lungs. Aortic stenosis may lead to blood and fluid backing up in the lungs, which causes congestion visible on an X-ray.

Electrocardiogram (ECG)

In this test, patches with wires (electrodes) are attached to the patient's skin to measure the electrical impulses given off by the heart. Impulses are recorded as waves displayed on a monitor or printed on paper. An ECG can provide clues about whether the heart's left ventricle is thickened or enlarged, which can occur with aortic stenosis.

Echocardiogram (Doppler Echocardiogram)

This test uses sound waves to produce images of the patient's heart. Through a wandlike device (transducer) held on the patient's chest, sound waves bounce off the heart and are reflected back through the chest wall and processed to produce video images of the heart and a close look at the aortic valve. A Doppler echocardiogram may be used to measure the volume of blood flowing backward through the aortic valve. This volume is expressed in cubic centimeters (cc) per heart beat.

Transesophageal Echocardiogram

Similar to a "regular" echocardiogram, this test uses a tiny transducer (sound device) on a tube inserted down the esophagus (part of the digestive tract that runs from the throat to the stomach). Because the esophagus lies close to the heart, having the transducer placed there provides an even more detailed image of the aortic valve and blood flow through the valve.

Exercise Tests

Different types of exercise tests help measure the patient's tolerance for activity and check the heart's response to physical exertion (exercise).

Cardiac Catheterization

In this procedure, a thin tube (catheter) is inserted in a blood vessel in the patient's arm or groin and threaded up to the heart. The catheter is used to deliver dye into the heart chambers and heart blood vessels. The dye, appearing on X-ray images as it moves through the heart, gives physicians detailed information about the heart and heart valves.

This test helps show blockage in arteries to the heart that can coexist with aortic stenosis and may need surgical treatment at the same time as the aortic stenosis.

Catheters used in cardiac catheterization at Mayo Clinic have miniature devices (sensors) at the tips that can measure pressure within heart chambers.

Diagnostic Imaging Scans

To provide more detailed, three-dimensional images of the heart, a patient may have a scan using:

Computed tomography (CT)

A CT scan uses a series of X-rays to create a detailed image.

Magnetic Resonance Imaging (MRI)

An MRI uses powerful magnets and radio waves to create a detailed image.

Positron Emission Tomography (PET)

A PET scan involves injecting the body with a small amount of radioactive glucose (tracer), which can be tracked by a special camera (positron) to provide detailed images. Read more about PET scanning at Mayo Clinic.

Mayo Clinic has other tests that use nuclear medicine (radioactive materials) for detailed imaging and advanced analysis of the heart and heart valves.