A 12-year-old boy is found to have an ejection systolic murmur over the aortic region with a precordial thrill and normal cardiac size on chest radiograph. The following is/are true:

d. In valvar aortic stenosis a pressure gradient of 80 mmHg is an indication for operative repair regardless of symptoms

e. In membranous subvalvar aortic stenosis a pressure gradient of 40 mmHg is an indication for operative repair

In the patient with findings of aortic stenosis, a systolic ejection click is evidence that the obstruction is valvular. Cardiac size does not provide an indication of the severity of the stenosis and is frequently normal. The development of angina or syncope reflects inadequate cardiac output and signifies late-stage disease. A pressure gradient over 75 mmHg is an indication for operation in valvar aortic stenosis even if the patient is asymptomatic while a lesser gradient of 30 mmHg or more is considered sufficient for operative correction of membranous subvalvar stenosis.