Diagnosis

To diagnose aortic valve stenosis, your doctor will review your signs and symptoms, discuss your medical history, and do a physical examination. He or she will listen to your heart with a stethoscope to determine if you have a heart murmur that may signal an aortic valve condition.

Tests

Your doctor may order several tests to confirm or rule out aortic valve stenosis. Tests also can help determine a cause and the condition's severity.

Tests for aortic valve stenosis may include:

• Echocardiogram. This test uses sound waves to create images of your heart in motion. A technician presses a device (transducer) firmly against your skin, aiming an ultrasound beam through your chest to your heart. The transducer records the sound wave echoes from your heart, and a computer converts the echoes into images that your doctor can view on a monitor.

  An echocardiogram can show your doctor how blood flows through your heart and heart valves. It can help identify a weakened heart muscle and determine the severity of aortic valve stenosis.

  If your doctor needs a closer look at your aortic valve, a transesophageal echocardiogram may be done. In this test, a flexible tube containing the transducer is guided down your throat and into your esophagus.

• Electrocardiogram (ECG or EKG). This painless test detects and records your heart's electrical activity using small sensors (electrodes) attached to your chest and arms and, sometimes, legs. An EKG can detect enlarged chambers of your heart, heart disease and abnormal heart rhythms.
• Chest X-ray. A chest X-ray can help your doctor determine whether your heart is enlarged, which can occur in aortic valve stenosis. It can also show swelling of the aorta and calcium buildup on your aortic valve.
• Exercise tests or stress tests. Exercise tests help your doctor determine whether signs and symptoms of aortic valve disease occur during physical activity. These tests can help determine the severity of your condition. If you are unable to exercise, medications that have similar effects as exercise on your heart may be given to complete the test.
• Cardiac computerized tomography (CT) scan. A cardiac CT scan combines several X-ray images to provide a more detailed cross-sectional view of the heart. Doctors may use cardiac CT to measure the size of your aorta and look at your aortic valve more closely.
• Cardiac MRI. A cardiac MRI uses magnetic fields and radio waves to create detailed images of your heart. This test may be used to determine the severity of your condition and evaluate the size of your aorta.

• Cardiac catheterization. This test isn't often used to diagnose aortic valve disease, but it may be used if other tests aren't able to diagnose the condition or to determine its severity. It may also be used before aortic valve surgery to make sure the arteries that feed the heart muscle (coronary arteries) are not blocked.

  In this procedure, your doctor threads a thin tube (catheter) through a blood vessel in your arm or groin and guides it to an artery in your heart.

  Sometimes, dye is injected through the catheter to help your arteries show up more clearly on an X-ray (coronary angiogram). A coronary angiogram gives your doctor a detailed picture of your heart arteries and how your heart functions. During the test, your doctor can also measure the pressure inside your heart chambers.