Echocardiograms for Heart Valve Disease

When you need the test—and when you don’t

Valve disease is caused by a heart valve that does not work the way it should. A test called an echocardio­gram can show how serious the problem is and if it is getting worse. But if your valve disease is mild, and it is not causing any symptoms, you probably don’t need to have the test every year.

Echocardiograms show pictures of the heart valves.

The heart has four chambers and four valves. Each time your heart beats, the valves open and close. This keeps blood flowing through the chambers and to your body. If a valve does not work well, blood can back up in a chamber. This makes the heart work harder to pump blood.

Valve disease is usually found during a regular medical exam. When your doctor listens to your heart, he or she may hear a noise called a murmur. Valve disease is one cause of heart murmurs. If you have a heart murmur, your doctor may recommend that you have an echocardiogram. This will depend on the sounds the doctor hears.

An echocardiogram is a simple test that uses sound waves to create images of your heart. The images can show whether your heart valves
are working properly and, if not, how serious the problem is.

Mild valve disease usually doesn’t cause problems.

If it is not treated, moderate or severe valve disease can lead to heart failure, stroke, blood clots, and other complications. Mild valve disease is not likely to cause complications. Often it does not get worse. If it does worsen, this happens very slowly.

If you don’t have symptoms and your doctor doesn’t hear anything unusual, your valve disease is probably mild and not getting worse. Having a yearly echocardiogram will not show anything new.

An echocardiogram could lead to other tests.

A standard echocardiogram is painless, safe, and does not expose you to radiation. If the test doesn’t show enough images of your heart, though, your doctor might order another procedure, called a transesophageal echocardiogram (TEE). During a TEE, a flexible tube is guided down your throat and into your esophagus (the “pipe” that runs from your throat to your stomach). It takes pictures of your heart from inside your esophagus.

Your throat may be sore for a few hours afterward. In rare cases the tube can cause injury to the throat. You could also have a bad reaction to the medicine given to help you relax. This can include nausea and trouble breathing. You also have to fast before that test, and you may need someone to drive you home. Why risk having the second test when you don’t even need the first one?

An echocardiogram can cost you a lot.

A standard echocardiogram and TEE can each cost $2,000 or more. If you do not have health insurance, you may have to pay the whole cost yourself. And even if you have insurance, you probably have a co-pay. This can be as much as half the cost of the test.

When should you have an echocardiogram for valve disease?

Your doctor will likely order an echocardiogram if:

  • Your heart murmur is fairly strong.
  • Your doctor finds signs that your disease is getting worse, such as a change in the murmur.
  • You develop symptoms of heart valve disease. These can include:
    • Unusual tiredness
    • Shortness of breath
    • Fever
    • Chest pain
    • Dizziness or fainting
    • Swelling in your ankles, feet, legs or abdomen
    • A fluttering, racing, or irregular heartbeat.

You may need tests more often if you have mild valve disease and you also have other heart conditions, or if you have moderate or severe valve disease, or if you have had a valve replaced.

This report is for you to use when talking with your health-care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2017 Consumer Reports. Developed in cooperation with the American College of Cardiology.