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Tests and diagnosis
By Mayo Clinic staffAs part of a routine physical, your doctor uses a stethoscope to listen to your heart. He or she is listening for, among other things, an abnormal heart sound (heart murmur).
If your doctor discovers a heart murmur, he or she will discuss it with you. Many heart conditions, including aortic valve stenosis, can produce a heart murmur. In the case of aortic valve stenosis, the heart murmur results from turbulent blood flow through the narrowed valve.
Diagnostic tests
If your doctor suspects that you or your child may have a deformed or narrowed aortic valve, you may need to undergo several tests to confirm the diagnosis and gauge the severity of the problem. You may be referred to a cardiologist — a doctor who specializes in the study of the heart and its function — for tests such as:
- 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 thickened or enlarged, a problem which can occur with aortic valve stenosis.
- Chest X-ray. An X-ray image of your chest allows your doctor to check the size and shape of your heart, to determine whether the left ventricle is enlarged — a possible indicator of aortic valve stenosis. A chest X-ray can also reveal calcium deposits on the aortic valve. In addition, a chest X-ray helps your doctor check the condition of your lungs. Aortic valve stenosis may lead to blood and fluid backing up in your lungs, which causes congestion that may be visible on an X-ray.
- 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 closely examine the aortic valve to check for problems. A specific type of echocardiogram, a Doppler echocardiogram, may be used to help your doctor determine the severity of your aortic valve stenosis and to check for any leakage (regurgitation).
- Cardiac catheterization. Your doctor may order this procedure if noninvasive tests haven't provided enough information to firmly diagnose the type or severity of your heart condition. Your doctor threads a thin tube (catheter) through an artery in your arm or groin to an artery in your heart. A dye injected through the catheter fills your heart's arteries, and the arteries become visible on an X-ray. This test helps show blockages in arteries to your heart that can coexist with aortic valve stenosis and may need surgical treatment along with aortic valve stenosis.
These tests and others help your doctor determine how narrow or tight your aortic valve may be and how well your heart is pumping. Once aortic valve stenosis is discovered, your doctor will either recommend treatment or suggest careful monitoring.
References
- Aortic valve stenosis (AVS). American Heart Association. http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Aortic-Valve-Stenosis-AVS_UCM_307020_Article.jsp. Accessed June 10, 2011.
- Rakel RE, et al. Valvular heart disease. In: Rakel RE. Textbook of Family Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2011. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4377-1160-8..10027-2--s0310&isbn=978-1-4377-1160-8&uniqId=258746827-3. Accessed June 12, 2011.
- Grimard BH, et al. Aortic stenosis: Diagnosis and treatment. American Family Physician. 2008;78:717.
- Aortic valve stenosis (AS) and aortic insufficiency (AI). American Heart Association. http://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_307649.pdf. Accessed June 12, 2011.
- Aortic stenosis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec07/ch076/ch076c.html. Accessed June 12, 2011.
- Otto CM, et al. Valvular Heart Disease. In: Bonow RO, et al. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4377-0398-6..00066-4&isbn=978-1-4377-0398-6&uniqId=258746827-3#4-u1.0-B978-1-4377-0398-6..00066-4--s0060. Accessed June 12, 2011.
- How the healthy heart works. American Heart Association. http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/How-the-Healthy-Heart-Works_UCM_307016_Article.jsp. Accessed June 12, 2011.
- Zigelman CZ, et al. Aortic Valve Stenosis. Anesthesiology Clinics. 2009;27:519.
- Carabello BA, et al. Aortic stenosis. In: Crawford MH. Current Diagnosis & Treatment: Cardiology. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/content.aspx?aID=3646810&searchStr=aortic+valve+stenosis#3646810. Accessed June 12, 2011.
- Coeytaux RR, et al. Percutaneous heart valve replacement for aortic stenosis: State of the evidence. Annals of Internal Medicine. 2010;153:314.
- Smith CR, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. New England Journal of Medicine. 2011;364:2187.
- Lockhart PB, et al. Poor oral hygiene as a risk factor for infective endocarditis-related bacteremia. Journal of the American Dental Association. 2009;140:1238.
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