Inclusion Criteria:  Patient consents to participation Willing to have heart sounds recorded with an electronic stethoscope Willing to undergo echocardiography Willing to undergo a 12-lead electrocardiogram Adults aged 55 years and older History of at least one of the following: hypertension, BMI ≥ 30, diabetes mellitus, hyperlipidemia, atrial fibrillation, myocardial infarction, stroke/TIA, previous coronary surgery, or previous coronary angiography No prior diagnosis of valve disease or heart murmur  Exclusion Criteria:  Patient is unwilling or unable to give written informed consent Patients experiencing a known or suspected acute cardiac event Under the age of 55 years old Prior diagnosis of valve disease or heart murmurs