Suspected mitral valve disease: clinical assessment

Echocardiography remains the diagnostic tool of choice when assessing valve disease. It is important that the patient is assessed appropriately, using physical assessment and history-taking during consultation. It is necessary for practitioners to understand the diagnostic tools, so the most appropriate investigations are carried out. Clinicians rely upon comprehensive history-taking and physical examination for accurate diagnoses, but assessing the severity of valvular heart disease relies upon quantitative measurements and data. The blurring of professional boundaries between health workers has resulted in nurses acquiring new skills and roles, enabling them to carry out consultation and diagnose patients. Advances in technology have resulted in a plethora of invasive and non-invasive diagnostic tools. Echocardiography is a form of ultrasound used routinely in modern health care and is widely accepted as an invaluable tool in the diagnosis and interpretation of the findings in structural heart disease. Mitral valve disease is increasing in prevalence in the context of the ageing population and optimal management, diagnosis and surveillance are crucial. A combination of subjective and objective data provide information for the clinician to formulate a differential, followed by a confirmed, diagnosis. The role of the specialist nurse has developed—they are often in charge of their own caseload of patients, and making autonomous decisions.