What is the diagnostic procedure for identifying a grade iii/iv systolic ejection murmur?

Diagnostic procedure: For older cardiologists like me physical exam after history often tells us what the cause and relative severity of the systolic murmurs is. The first test we generally order specific to the 'murmur' is the echocardiogram, this generally gives a very good indication of the valve problem and its severity. If necessary we might go on to other testing such as cardiac catheterization.