It is important for radiologists, especially those in training, to understand the clinical basis of valvular heart disease as well as the radiologic features. Only with this background can we participate in the cardiovascular team and provide added diagnostic value to our patients and referring physicians. As the complexity of cardiac imaging grows, new opportunities arise. Developments in CT and MR imaging could have a profound influence on the investigation and management of future cardiac patients, therefore, it is essential that radiologists take an active interest. If we do not, then past experience has shown that we will be excluded.