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Diagnosing valvular regurgitation begins with the physician obtaining the patient’s full medical history and giving the patient a physical examination. As part of the physical examination, the physician will listen to the patient’s heart through a stethoscope. The physician will also listen to the patient’s pulse. Certain murmurs and telltale pulse motion characteristics, such as the “water hammer” pulse, can help physicians determine whether a valve defect is present and, if so, pinpoint its cause and severity.
The next diagnostic step will be an electrocardiogram (EKG). This is a recording of the heart’s electrical activity as a graph on a moving strip of paper or video monitor. The highly sensitive electrocardiograph machine helps detect heart irregularities, disease and damage by measuring the heart’s rhythms and electrical impulses. This test can indicate if any of the heart’s chambers are enlarged (the left ventricle in particular) and if arrhythmias are occurring.
If the patient’s history, physical examination and EKG suggest the presence of valvular regurgitation, then additional tests will be ordered. Noninvasive tests include:
- Echocardiogram. This test uses sound waves to visualize the structures and functions of the heart. A moving image of the patient’s beating heart is played on a video screen, where a physician can study and measure the heart’s thickness, size and function. The image also shows the motion pattern and structure of the four heart valves, revealing any potential leakage (regurgitation). During this test, a color flow Doppler ultrasound is required to assess the severity of the regurgitation.
- Chest x-ray. A radiation-based imaging test that offers the physician a picture of the general size, shape, and structure of the heart and lungs. An enlarged heart can indicate damage or dysfunction.
If these noninvasive tests do not offer enough information, then an invasive procedure called a cardiac catheterization may need to be done. During the cardiac catheterization, pressure measurements will be taken within the heart using catheters to determine the severity of the leakage, and a coronary angiogram may be done to ensure the coronary anatomy is normal. To perform the angiogram, the physician injects a special dye (contrast medium) into the coronary arteries. To do this, the physician inserts a thin tube (catheter) through a blood vessel, usually in the upper thigh, and  up into the origin of the coronary arteries. Once the catheter is in place, the physician can inject the dye through the catheter and into the coronary arteries. Then the x-ray can be taken. Following the coronary angiogram, a left ventricular angiogram will be performed. An aortogram may also be done to assess aortic regurgitation. | 
