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If such narrowing occurs without aortic insufficiency at the age at which it usually occurs, it may not seriously affect the heart. It may follow acute endocarditis, but it most frequently follows chronic endocarditis or atheroma, in which the aortic valves become thickened and more or less rigid; this condition most frequently occurs in men.
#Sacculated Aneurysm.# When a limited area of the vessel wall is weakened for example by atheroma or by other form of arteritis this portion yields before the pressure of the blood, and a sacculated aneurysm results.
To this stage in the process the term atheroma is applied. The endothelium over these plates often disappears, leaving them exposed to the blood-stream. Changes of a similar kind sometimes occur in the middle coat, the lime salts being deposited among the muscle fibres in concentric rings.
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