Write an article based on this "Have your doctor listen for a heart murmur with a stethoscope. Get a chest x-ray. Consider an ECG (electrocardiogram). Receive an echocardiogram to definitively diagnose mitral stenosis."
Mitral stenosis often presents with a heart murmur that can be heard when your doctor listens with his or her stethoscope. Although this is not enough to diagnose mitral stenosis, it is suspicious of a heart problem and would be an indication for your doctor to order further investigative tests. A chest x-ray is normally one of the first tests your doctor will order, if he or she suspects a lung and/or a heart problem, such as mitral stenosis. A chest x-ray allows your doctor to examine your lungs for fluid build-up (called "pulmonary edema") which may go hand-in-hand with mitral stenosis. Your doctor can also evaluate for enlargement of any of the chambers of your heart, such as the right atrium, which may also be a sign of mitral stenosis.  A chest x-ray is also useful in ruling in or ruling out other heart or lung conditions that may present similarly to mitral stenosis. It is for this reason that it is normally one of the first investigative tests that is ordered. In the evaluation of heart or lung problems such as mitral stenosis, an ECG (sometimes accompanied by an exercise stress test) can be helpful. An ECG is able to detect the amount of "stress" on the heart in various situations. In order to confirm the diagnosis of mitral stenosis (or of any other form of valvular heart disease), an echocardiogram is needed. The first type performed will normally be a TTE (transthoracic echocardiogram). In a TTE, the ultrasound probe is placed on the outside of your chest. It then projects a real-time, colored, moving image of the heart on a screen, where the doctor can look at the structure of your heart as well as the flow of blood with each heartbeat.  The color in the TTE can help indicate the flow of blood. A TTE may be sufficient to observe and confirm the diagnosis of mitral stenosis. If it is not, a TEE (transesophageal echocardiogram) may be ordered. In a TEE, rather than the ultrasound probe being placed on the outside of your chest, it is inserted into your esophagus. Your esophagus is much closer to your heart anatomically, so a TEE can provide a much more detailed view than a TTE, which can aid in the diagnosis of mitral stenosis.