Review Question - QID 211092

A 67-year-old woman is referred to a gastroenterologist for a history of intermittent bloody stools over the past 4 months. She says that she has had these episodes a few times a month, and occasionally notes mild amounts of dark red blood in the toilet bowl. She denies recent weight loss or weight gain, changes in the caliber of her stools, fatigue, or palpatations. Fecal occult blood test in office is positive, and complete blood count is consistent with a hypochromic, microcytic anemia. A decision is made to undergo colonoscopy. A lesion is identified, and is pictured in Figure A. Electrocautery during colonoscopic evaluation causes cessation of the bleeding. Which of the following findings is most likely on cardiac auscultation?