How to handle valvular heart disease in daily practice

Echocardiography is the most popular technique in the evaluation of valvular heart disease. It provides detailed real time anatomical information on the leaflets and flow analysis by Doppler evaluation. Moreover, it is considered useful in the functional evaluation of the ventricles. Echocardiography is considered a relatively cheap modality, widely present in the territory. Magnetic Resonance Imaging (MRI) provides useful information in the same cases. It is considered the choice modality in the functional evaluation of the heart giving useful information for the surgical timing especially in the most severe cases. Moreover, with MRI it is possible to obtain flow measurements similar and sometimes superior to those obtained with Doppler. Finally, the evaluation of the leaflets is extremely improved by the use of bright blood steady state sequences. It is possible to distinguish aortic bicuspid valve and stenosis or insufficiency. For these reasons, cardiac MRI is an alternative in cases of poor acoustic window or to improve delineation of anatomical detail useful for determination of the cause. MDCT may improve the visualization of the calcifications and now provide a detailed delineation of the leaflets. Quantification of stenotic and insufficient valve is also possible with good echocardiographic correlation. Improved temporal resolution will increase the accuracy of CT diagnosis of valve disease and, especially in the endocardities, morphological alterations of the leaflets. Learning Objectives: 1. To understand the pathophysiology. 2. To present the different methods of imaging. 3. To familiarise with the advantages and limitations of each method.