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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 diagnosis 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.
- Aortic valve stenosis (AS) and aortic insufficiency (AI). American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=1659. Accessed July 6, 2009.
- Aortic stenosis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec07/ch076/ch076c.html. Accessed July 6, 2009.
- Grimard BH, et al. Aortic stenosis: Diagnosis and treatment. American Family Physician. 2008;78:717.
- Otto CM, et al. Valvular heart disease. In: Libby P, et al., eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-1-4160-4106-1..50065-0&uniq=148441160&isbn=978-1-4160-4106-1&sid=860585891. Accessed July 6, 2009.
- Otto CM. Pathophysiology and clinical features of valvular aortic stenosis in adults. http://www.uptodate.com/home/index.html. Accessed July 6, 2009.
- Ardehali R, et al. Valvular heart disease. In: Nilsson KR, et al. The Osler Medical Handbook. Philadelphia, Pa.: Saunders Elsevier; 2006. http://www.mdconsult.com/das/book/body/148441160-4/860446560/1387/28.html#4-u1.0-B0-323-03748-8..50017-8_181. Accessed July 6, 2009.
- Carabello BA. Valvular heart disease. In: Goldman L, et al., eds. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/148441160-6/860446560/1492/318.html#4-u1.0-B978-1-4160-2805-5..50080-X_3105. Accessed July 6, 2009.
- Otto CM. Medical therapy in asymptomatic aortic stenosis in adults. http://www.uptodate.com/home/index.html. Accessed July 6, 2009.
- Grogan M (expert opinion). Mayo Clinic, Rochester, Minn. July 19, 2009.
