Except in: Mod–Severe MAC, any MS, MV replacement, Mod–Severe primary MR, Severe AI, A-fib, LVAD, Mod–Severe non-cardiac PH, tachycardia, RCM/HCM, transplant, or pericardial constriction.
Grading follows ASE’s 2025 general algorithm (age & special populations excluded here).