A physical exam and review of your medical history are important first steps in diagnosing aortic valve stenosis. If you have stenosis but no symptoms, your doctor will likely find the condition during a routine exam or a checkup for another health problem. A distinctive heart murmur is usually the first clue that leads a doctor to suspect aortic valve stenosis.

During the physical exam, the doctor will:

• Take your blood pressure. Low blood pressure may mean that not enough blood is getting through the narrowed aortic valve.
• Check your pulse. A weak pulse may mean there is narrowing of the heart valve.
• Listen to your heart and lungs for abnormal sounds. A soft whooshing or humming sound (murmur) heard through a stethoscope is an important finding that often indicates heart valve disease. Abnormal sounds in the lungs can indicate fluid buildup in the lungs that is caused by heart valve disease.
• Look at your legs and feet. Swelling in the legs and feet may be a sign of heart failure.

After the exam

Your doctor may want to do an echocardiogram to confirm that your symptoms and the results of your exam are caused by aortic valve stenosis. The echocardiogram will also tell your doctor:

• How severe the stenosis is.
• How wide your aortic valve can open.
• The difference in pressure between the heart and the aorta, resulting from blood being forced through the narrowed valve.
• The size of your left ventricle.
• How well your left ventricle is working.
• Whether there are problems with other valves.

Tests for aortic valve stenosis

• Echocardiogram (echo). If you have aortic valve stenosis, an echocardiogram may show thickened aortic valve leaflets that aren't moving normally.
• Stress echocardiogram. A stress echocardiogram can show how severe your aortic valve stenosis is and how it affects how much you can exercise.
• Electrocardiogram (EKG or ECG). An electrocardiogram may show abnormalities in heart rhythm or lower left heart chamber (ventricle) thickness.
• Chest X-ray. A chest X-ray may show calcium buildup in the valve, an enlarged left ventricle, or fluid buildup if you have developed heart failure. In some cases, the aorta may be enlarged just beyond the aortic valve.
• Brain natriuretic peptide (BNP) test. A BNP test may help show how well your heart is working and if you have heart failure.
• Coronary angiogram/catheterization. Cardiac catheterization is the most accurate way to see how narrow the valve is.