Tests and diagnosis

By Mayo Clinic Staff

Identifying aortic valve regurgitation early is important because the condition can worsen with time, and you may need surgery to correct it.

Your doctor may first suspect that you have aortic valve regurgitation during a routine office visit after listening to your heart with a stethoscope and hearing an abnormal heart sound (heart murmur). Blood leaking through the aortic valve often makes a distinct sound.

To begin the evaluation of your heart, your doctor will ask you questions about your personal and family health history. Next your doctor will perform a physical examination that concentrates on your heart.

From this information, your doctor decides what tests you may need in order to make a diagnosis and develop a treatment plan. For testing, you may be referred to a cardiologist — a doctor who specializes in the study of the heart and its function.

Diagnostic tests

Other heart problems can cause signs and symptoms similar to those of aortic valve regurgitation, and it's possible to have more than one disorder at the same time. Common tests doctors use to diagnose aortic valve regurgitation include:

  • Echocardiogram. This test uses sound waves to produce an image of your heart. In an echocardiogram, sound waves are directed at your heart from a wand-like device (transducer) held on your chest. The sound waves bounce off your heart and are reflected back through your chest wall and processed electronically to provide video images of your heart. An echocardiogram helps your doctor get a close look at your aortic valve. A specific type of echocardiogram, a Doppler echocardiogram, may be used. It allows measurements of the volume of blood flowing backward through an aortic valve. This volume is expressed in cubic centimeters per beat.
  • Chest X-ray. With an X-ray of your chest, your doctor can study the size and shape of your heart to determine whether your left ventricle is enlarged — a possible sign of damage to the aortic valve.
  • Electrocardiogram (ECG). In this test, patches with wires (electrodes) are attached to your skin to measure the electrical impulses given off by your heart. Impulses are recorded as waves displayed on a monitor or printed on paper. An ECG can provide clues about whether the left ventricle is enlarged, a problem which can occur with aortic valve regurgitation.
  • Transesophageal echocardiogram. This type of echocardiogram allows an even closer look at your aortic valve. The esophagus, the tube that runs from your throat to your stomach, lies close to your heart. In a traditional echocardiogram, a device called a transducer is moved across your chest to produce the sound waves necessary to create the image of your beating heart. In a transesophageal echocardiogram, a small transducer attached to the end of a tube is inserted down the esophagus. Because the esophagus lies close to your heart, having the transducer there provides a clearer picture of your aortic valve and blood flow through it.
  • Exercise tests. Different types of exercise tests help measure your tolerance for activity and check your heart's response to exertion (exercise).
  • Cardiac catheterization. Your doctor may order this procedure if noninvasive tests haven't provided enough information to firmly diagnosis the type or severity of your heart condition. Your doctor threads a thin tube (catheter) through a blood vessel in your arm or groin, into your heart. Dye is injected through the catheter into your heart, making details visible on an X-ray. Cardiac catheterization can show if blood is leaking back from the aorta into the heart's left ventricle. Some catheters with special sensors also can measure pressure within heart chambers, such as the left ventricle. Pressure may be increased in the left ventricle with aortic valve regurgitation.

These tests help your doctors diagnose aortic valve regurgitation, determine how serious the problem is, and decide whether your aortic valve needs repair or replacement.

Sep. 22, 2011