Assessment
The severity of symptoms depend on degree of obstruction. In case of severe obstruction, ECG shows right ventricular or biventricular hypertrophy. Cardiac catheterization and angiography reveals intercommunication between pulmonary and systemic circulation to outflow, there may be fatigue due to exercise intolerance, dizziness, fainting and episodes of pulmonary oedema. There may be faint peripheral pulses and anginal pain because of decreased cardiac output and in severe stenosis death may occur. On auscultation there is coarse systolic ejection murmur accompanied by thrill over the aortic area and a diastolic murmur can occur with aortic insufficiency. Diagnosis is confirmed by chest X-ray, ECG echocardiogram and cardiac catheterization etc.
Management
Surgical intervention done in these cases consists of valvotomy which is performed to divide the fused cusps, if stenosis is at the valvular level. Supra or subaortic stenosis is corrected through excision of the obstructing tissue.