Patient presents with symptoms suggestive of heart valve disease.  Presenting complaints include shortness of breath (dyspnea), chest pain (angina), fatigue, palpitations, and dizziness or syncope.  Physical examination reveals a heart murmur, the character of which (e.g., systolic, diastolic, location, radiation) is documented.  Relevant medical history includes hypertension, hyperlipidemia, rheumatic fever, coronary artery disease, and family history of heart valve disease.  Diagnostic evaluation may include echocardiogram (transthoracic echocardiography, TTE, or transesophageal echocardiography, TEE) to assess valve structure and function, electrocardiogram (ECG or EKG) to evaluate heart rhythm, cardiac catheterization for hemodynamic assessment, and chest x-ray to assess heart size and pulmonary congestion.  Assessment includes specifying the affected valve (aortic, mitral, tricuspid, pulmonary), the type of dysfunction (stenosis, regurgitation, prolapse), and severity (mild, moderate, severe).  Differential diagnoses considered include other causes of cardiac murmurs, heart failure, coronary artery disease, and pulmonary hypertension.  Treatment plan may include medications for symptom management (e.g., diuretics, ACE inhibitors, beta blockers), lifestyle modifications (e.g., sodium restriction, exercise), and interventions such as valve repair or replacement surgery (surgical valve replacement, transcatheter aortic valve replacement, TAVR).  Patient education provided on disease process, medication management, and follow-up care.  Follow-up appointments scheduled for ongoing monitoring of symptoms, echocardiographic evaluation, and optimization of medical therapy.