Echocardiography is recommended in patients with classic symptoms of aortic stenosis. accompanied by a systolic murmur and in asymptomatic patients with a grade 3/6 or louder. systolic murmur. C 19. Aortic valve replacement is the only effective treatment for patients with severe symptomatic. aortic stenosis. B 25, 26. Watchful waiting is recommended for most patients with asymptomatic aortic stenosis, including those with severe disease. B 28, 30, 31.