[Stress echocardiography in valvular heart disease]

The assessment of the severity of a valvular lesion traditionally relies on the evaluation of valvular anatomy and on the demonstration of resting hemodynamic disturbances. In patients with stenotic lesions, this is usually achieved by measuring the trans-stenotic pressure difference and by calculating the surface of the stenotic orifice. In patients with regurgitant lesions, assessment of lesion severity involves the demonstration of a significant volume or pressure overload of the various chambers participating in the process. In many instances, however, discrepancies are found between the severity of valvular lesions and either the symptoms or the hemodynamic impairment. As echocardiography is also the method of choice for assessing the severity of valvular disease, stress echocardiography may offer the unique opportunity to assess the hemodynamic consequences of valvular lesions both at rest and during stress.