What echocardiographic findings are most indicative of valvular heart disease?

Echocardiographic findings most indicative of valvular heart disease include structural and functional abnormalities of the heart valves such as stenosis or regurgitation, valve leaflet thickening or calcification, restricted leaflet motion, and abnormal flow patterns across the valves detected by Doppler imaging. Specifically, in aortic stenosis, echocardiography reveals increased peak aortic jet velocity (Vmax >5 m/s), reduced aortic valve area (<0.6 cm2), and elevated transvalvular gradients, alongside left ventricular ejection fraction (LVEF) assessment to evaluate ventricular function NICE NG208.

For aortic regurgitation, key echocardiographic indicators include the presence of a regurgitant jet, measurement of left ventricular end-systolic diameter (ESD >50 mm or indexed ESDI >24 mm/m2), and LVEF less than 55% NICE NG208.

Mitral valve disease is identified by leaflet thickening, restricted motion in stenosis, and regurgitant jets in mitral regurgitation, with echocardiography assessing severity and ventricular response NICE NG208.

Doppler echocardiography is essential for quantifying valve gradients and regurgitant volumes, while 2D and 3D imaging provide detailed valve morphology and function assessment Bax & Delgado 2017. Advanced imaging techniques, including stress echocardiography, can unmask symptoms and assess valve disease severity when resting echocardiographic findings are inconclusive NICE NG208.

In prosthetic valves, echocardiographic evaluation focuses on leaflet motion, presence of obstruction or regurgitation, and paravalvular leaks, guided by specific imaging protocols Zoghbi et al. 2024. Correlation of murmurs with echocardiographic findings supports clinical suspicion and guides referral decisions Saeed et al. 2023.