Ejection systolic murmur over 1st aortic area radiating to the carotid = Organic valvular aortic stenosis ( AS) .
AS+ paradoxical splitting of 2nd heart sound or late murmur peaking = valvular severe AS.
AS+ facial dysmorphism or higher right UL pressure = supravalcular AS ( William syndrome) .
AS+ PDA or history of Turner = Bucuspid AV stenosis .
Ejection systolic murmur at 2nd aortic area or lower increasing in intensity with Valsalva and standing and decreasing with squatting = HOCM.
Moderate AS= follow up with yearly echo
Severe AS with symptoms or low EF below 50%= valve replacement (surgical or TAVI).
Severe valvular AS in young child = ballon valvuloplasty .