Pathologists and surgeons often encounter cardiac valves with focal or patc
hy abnormalities either at postmortem examination or during the assessment
of a valve removed at surgery. Many health professionals including nurses,
cardiologists, echocardiographers, sonographers and radiologists may be cal
led upon to assess these lesions. With the development of increasingly more
sophisticated and sensitive imaging techniques, including transesophageal
echocardiography and magnetic resonance imaging, more valve lesions are bei
ng discovered. Many patients with metabolic abnormalities, systemic disease
s or storage disease have valvular findings. Some are characteristic and di
stinctive for the specific disease, while others are seen in numerous disea
ses. Most patients develop age related valvular changes, and these are more
frequently encountered with the aging population. A practical approach the
health professional should take to assess these valve lesions is given. Th
e major categories of disease that produce focal lesions of the cardiac val
ves are presented.