RADIOLOGY The Radiological Diagnosis of Cardiac Valvar Insufficiencies

THE RADIOLOGICAL DIAGNOSIS of cardiac valvar insufficiency includes the description and identification of the insufficient valve or valves and their supportive structures, quantitation of the regurgitant flow, determination of the degree of myocardial functional deterioration that may be present, and detection of associated cardiac lesions. Cardiac catheterization with selective angiocardiography provides most, if not all, of this information. However, cardiac catheterization and angiocardiography are not without risk. They are expensive, time consuming, and uncomfortable for the patient, and therefore are not employed untiltheir need has been demonstrated by other, less elaborate diagnostic methods. In the screening phase of the diagnostic workup of the patients with cardiac valvar insufficiency, such radiological tools as fluoroscopy with cineradiographic recording and, in particular, chest radiography are standard procedures. Although they may be very useful for specific diagnostic problems, the more recently added diagnostic techniques, such as isotope imaging and sonocardiography, have not as yet significantly reduced the need for conventional radiographic methods. With further methodological development, these tools may be expected to play a more significant role, particularly in follow-up examinations. This communication is concerned with the conventional radiological methods of diagnosing cardiac valvar insufficiency: fluoroscopy, chest films, and selective angiocardiography.