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May 1938


Arch Intern Med (Chic). 1938;61(5):781-797. doi:10.1001/archinte.1938.00180100091010

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PATHOLOGIC PICTURE  After Mönckeberg's first description of the pathologic picture of calcific aortic stenosis, in 1904, this lesion for years was reported only rarely and was recognized only at postmortem examination. In recent years, however, clinical and roentgenologic studies have allowed its recognition during life without difficulty.Various authors (Mönckeberg, Ribbert, Margolis, Ziellessen and Barnes, Giese, Martens and others) have investigated the underlying pathologic condition, and their findings will be reviewed here as they are necessary for a better understanding of the clinical and roentgenographic aspects. The involvement affects the aortic ring, primarily at the roots of the valves. In the first stage of the disease only the outer layer at the site of the sinus of Valsalva is affected. Calcification then extends into the leaflets or into one of the commissures, bulges into the sinuses of the valves or forms radiating or circular buckles within the valves themselves. Deposits

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