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.