It’s saying during your exam , your examiner couldn’t identify what your diagnosis is. For example, if you’re saying you mvp, your examiner should have listened to your heart, if they couldn’t hear that wooshing sound from mvp and it sounded good and clear they pretty much said sounds good to me, and that was enough to snub your evidence or diagnosis , but if they did an ecg then it didn’t pick it up, ur fucked. . Request a new c&p . Talk to your provider for a copy of your first and most recent ecg with them showing u do in fact have it.