Diagnosing Aortic Valve Disease

Because patients often don’t have any symptoms of aortic valve disease, the first indication is sometimes when their primary-care physician hears a heart murmur.

Contact your doctor if you have been told you have a heart murmur and you experience any of the symptoms of aortic valve stenosis or aortic valve regurgitation. Your doctor will discuss your medical history and your symptoms, and conduct a physical examination. Your doctor may also order one or more specialized tests, such as:
  • Echocardiogram (Echo). This test uses ultrasound to create an image of the heart. The ultrasound waves bounce or “echo” off the heart to show the size, shape and movement of the heart’s chambers and valves, and also the blood flow. The ultrasound waves are created by a machine called a transducer. The transducer can be placed on your skin or very small transducer can be inserted into your esophagus.


On left, see echocardiogram of patient with aortic stenosis, showing minimal leaflet opening. On right, see gradient which measures severity of stenosis.

  • Electrocardiogram (ECG). This procedure uses sensors placed on your chest to measure the electrical activity of your heart. The reading from the test is called an electrocardiogram.
  • Chest X-ray.
  • Cardiac catheterization. In this procedure a small, flexible tube called a catheter is placed in the heart to allow a detailed evaluation of the heart or to perform a procedure. Also known as cardiac cath or heart cath. 

In inset, see angiography of patient with aortic stenosis, showing minimal leaflet opening. In main picture, see angiography after TAVR valve placement.

  • Exercise stress test. This test will see how well your heart functions during activity, typically walking on a treadmill or riding a stationary bike while a technician monitors your heart rhythm, blood pressure and breathing. Also known as a stress test. 
  • Pharmacologic stress test. This test uses drugs to put stress on the heart to test how well the heart functions.
  • CT scan (computed tomography scan). This imaging technology uses a computer to combine a series of X-ray images from different angles to create an image that shows a slice or cross-section of a portion of the body. Also known as CAT scan.

On left, video showing scroll through a patient’s trileaflet aortic valve with calcium (white). On right, a video showing the blood vessels from the neck to the legs. This will be used to help determine the appropriate access method to deliver a transcatheter aortic valve.

The video below is from a TAVR CTA scan, it is a 3D volume rendering of the heart anatomy blood vessels.

  • MRI (magnetic resonance imaging). This imaging technology uses a magnetic field and radio waves to create images of organs and tissues inside the body.
Depending on your examination and test results, your doctor may recommend careful monitoring for a while, or refer you to the specialists at the Structural Heart and Valve Disease program at the Swedish Heart & Vascular Institute (SHVI) in Seattle.

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