Role of Stress Echocardiography in Mitral Valve Disease

Echocardiography is pivotal in the evaluation and management of valvular heart disease. Conventionally, echocardiographic assessment of any valve disease is performed at rest. However, as valvular heart disease is a dynamic entity, evaluation only at rest is not sufficient to assess the true hemodynamic severity of the valve lesion. For this reason, stress echocardiography (SE) serves as a useful diagnostic modality. By permitting evaluation under hemodynamic stress, it provides incremental diagnostic and prognostic information which has significant therapeutic implications. Further, exercise SE also permits correlation of the symptoms with the severity of the underlying valve disease. This information is crucial as the development of symptoms is a Class I indication for intervention in valve disorders. These benefits coupled with the easy availability and safety of SE should lead to its more routine application in the management of the patients with valvular heart disease. The present review describes the technical aspects and the clinical utility of SE in the evaluation and management of mitral valve disease.