Hello Lisa. I am convinced that I have an issue with one of my valves. Longstanding symptoms of inability to build exercise tolerance, shortness of breath, chest pressure, palpitations, fluid retention since 2006. I had a work-up at Mayo, MN 2012. No answers. I can not get my doctors in Chicago to move beyond a 2 D echo because they feel the echo needs to show something suspicious before they will do a left heart cath or a trans-espophageal echo. Ive had a bike echo, CPX, R heart cath, coronary angiogram and several 2 D echos .Are there any other test that might show a valve issue better than a 2 D echo? I don't understand why they will not do more tests given the length of time I've had the symptoms. I even had a cardiac stress MRI but none of the tests they have done are with specific valve protocol. I just don't understand. I'm also wondering if Mayo, AZ has just as much expertise with valve disease and surgeries as Mayo MN. I don't have any family here in Chicago and my daughter lives in AZ and wants me to be seen there if they have just as much expertise in this area. Please advise if you can. Thank you.