Modifies a noun

• disease: All patients with evidence of heart failure without valvular disease will be encouraged to commence ACE inhibitors.

• lesion: Patients with cardiac disease, especially significant shunts or stenotic valvular lesions, are vulnerable to these changes.

• incompetence: On examination of the distribution of the varicose veins might suggest the site of valvular incompetence.

• defect: His Treatise on the diseases of the heart is said to include some of the finest clinical descriptions of valvular defects ever written.