Noninvasive graphic evaluation: phonocardiography and echocardiography.

Noninvasive graphic techniques are an invaluable tool in the diagnosis, management, and followup of patients with valvular heart disease. They are both sensitive and specific and therefore often eliminate the need for more invasive and more expensive diagnostic procedures. When cardiac catheterization and/or cineangiography are necessary to obtain definitive hemodynamic or anatomic information, prior noninvasive graphic evaluation frequently directs the cardiologist to the appropriate type of study to be performed. This is especially true of subtle tricuspid valvular disease, unsuspected silent stenotic valvular lesions, or unusual causes of aortic regurgitation. Because these studies are noninvasive and can be repeated as often as necessary, they are ideal techniques for the longitudinal followup of the patient. Additionally, these techniques are excellent teaching tools, and they allow cardiologists to continually check and refine their clinical skills, which are the foundation of the bedside evaluation of the patient with valvular heart disease.