Which diagnostic tests are recommended for confirming the presence of valvular heart disease in primary care?

Recommended diagnostic test in primary care for confirming valvular heart disease is echocardiography. Consider an echocardiogram for adults with a murmur and no other signs or symptoms if valve disease is suspected based on the nature of the murmur, family history, age (especially if over 75), or medical history such as atrial fibrillation. Offer an echocardiogram to adults with a murmur if valve disease is suspected and they have signs (e.g., peripheral oedema), symptoms (e.g., angina or breathlessness), or an abnormal ECG, or an ejection systolic murmur with a reduced second heart sound but no other signs or symptoms. If valve disease is suspected with a systolic murmur and exertional syncope, or severe symptoms thought related to valve disease, urgent echocardiography (within 2 weeks) is recommended. Other tests such as ECG may support suspicion but echocardiography is the key diagnostic tool to confirm valvular heart disease in primary care before specialist referral.