text: An echocardiogram is the diagnostic study of choice in a patient with a<unk> , and should be obtained in asymptomatic patients with diastolic<unk> s, continuous<unk> s, holo-systolic<unk> s, late systolic<unk> s,<unk> s associated with ejection clicks or<unk> s that radiate to the neck or back as well as a grade 3 or louder midpeaking systolic<unk> .  An echocardiogram should also be obtained in patients with evidence of myocardial infarction or ischemia,<unk>  failure, congenital<unk>  disease, syncope, endocarditis. <unk> c evaluation is not recommended in some<unk> s, such as a grade 2 or softer mid-systolic<unk> , which can be an "innocent", "benign" or "functional".
option_0: Heart murmur echocardiography
option_1: Mitral regurgitation physical examination
option_2: Aortic regurgitation physical examination
option_3: Pulmonic regurgitation physical examination
option_4: Tricuspid regurgitation physical examination
option_5: Mitral stenosis physical examination
option_6: Tricuspid stenosis physical examination
option_7: Tricuspid stenosis electrocardiogram