[Echocardiography is necessary to confirm the presence and severity of valvular heart disease].

Cardiac auscultation remains the most important method of screening for valvular heart diseases. Echocardiography is recommended for symptomatic patients or even asymptomatic patients with heart murmurs. Echocardiography is one of the most important examinations for the diagnosis and assessment of severity of valvular heart diseases. The severity of the aortic or mitral stenosis can be defined with Doppler echocardiographic measurements of maximum jet velocity, mean transvalvular pressure gradient, which can be measured from the continuous-wave Doppler signal across the valve with the modified Bernoulli equation, and continuity equation valve area. Planimetry of the orifice area may be possible from the short-axis view. The mitral valve area can also be derived from Doppler echocardiography with the diastolic pressure half-time method. In addition to semiquantitative assessment of the severity of aortic or mitral regurgitation by color flow jet area by Doppler echocardiography, quantitative measurement of regurgitant volume, regurgitant fraction, and regurgitant orifice area can be performed. Indirect measures of severity of aortic regurgitation are helpful, using the rate of decline in regurgitant gradient measured by the slope of diastolic flow velocity, or using the degree of reversal in pulse wave velocity in the descending aorta