You should have a physical exam periodically, with the frequency depending on your age, overall health, and risk factors for various conditions. Most heart valve problems are discovered by a doctor while listening to the heart with a stethoscope. If your doctor finds aortic valve regurgitation during a routine physical, the condition will likely not have progressed to the point of being severe and needing immediate treatment. By treating the condition early, you may be able to extend, possibly even by several years, the time before you need valve replacement surgery. Because all artificial valves eventually wear out, this could mean one fewer valve replacement in your lifetime.

In testing for aortic valve regurgitation, your doctor will try to determine whether you have the condition and what type of regurgitation you have (acute or chronic). The doctor also will want to assess how severe the regurgitation is and whether you have any complications, such as abnormal heartbeats (arrhythmias) or heart failure.

A medical history and physical exam are a routine part of any evaluation of how well your heart is working. Aortic valve regurgitation can generally be diagnosed by physical exam.

Further testing may be needed to determine how much the valve is leaking. Tests also are needed if you have symptoms, because they can easily be confused with symptoms of several other heart conditions, including coronary artery disease (CAD) and heart failure. Aortic valve regurgitation also can be confused with other heart valve conditions.

During the physical exam, your doctor will listen for an extra heart sound (a murmur). If you have a certain type of heart murmur, your doctor may suspect aortic valve regurgitation and suggest further tests, which may include:

• Echocardiogram (echo)/transesophageal echocardiogram (TEE). Echocardiography (echo) can be used to look at the heart valves and the shape of the leaflets and to see whether the valves are leaking. Echocardiograms also measure the ability of the lower left heart chamber (left ventricle) to fill with blood and pump properly. Echo also helps measure heart size and may show whether the heart muscle is abnormally thickened because of aortic valve regurgitation. Health professionals use an echo to guide treatment decisions, such as whether to perform valve surgery, which may be needed if there is evidence of an enlarged left ventricle (a sign of heart failure).
• Electrocardiogram (ECG, EKG). The results of electrocardiography (electrocardiogram) may show abnormal electrical activity, suggesting that your heart is enlarged or has an increased workload caused by the backflow of blood or by an arrhythmia.
• Chest X-ray. If you have aortic valve regurgitation, a chest X-ray may show that the lower left ventricle is enlarged. In some cases, the blood vessel leaving the heart (aorta) may be enlarged just beyond the aortic valve.
• Exercise electrocardiogram. Exercise electrocardiography may be needed to see how the heart responds to exercise in a person who does not exercise regularly or when symptoms are present.
• Angiogram/aortogram. During an angiogram of the aorta (aortogram), a thin, flexible tube called a catheter is placed into the femoral artery in the upper thigh and threaded to the left ventricle and aorta. Dye is then injected through the catheter, and the flow of the dye through the aortic valve can help determine how much the aortic valve is leaking. Also, coronary angiogram, in which the coronary arteries are viewed, is usually done at the same time.
• Radionuclide ventriculogram (nuclear scanning). Ventriculography can measure how well the left ventricle is pumping and how much blood is pumped out of the chamber with each heartbeat.

If you have aortic valve regurgitation, you will see your doctor for regular exams including an echocardiogram. How often you have an echocardiogram depends on the severity of your regurgitation. Mild regurgitation requires an echocardiogram every 2 to 3 years, a moderate condition requires an echo every year, and with severe regurgitation you may have to have an echo every 4 to 6 months.