Global Burden of Rheumatic Heart Disease

• Published in: The New England journal of medicine Vol. 378; no. 1; p. e2
• Main Authors: Sohrabi, Bahram, Ranjbar, Abdolmohammad, Johannsen, Ronald A, Shroff, Gautam R, Jain, Yogesh, Juneja, Rajnish, Patil, Sushil, Dickinson, James A, Johnston, Ian, Rossi, Gabriele, Watkins, David A, Roth, Gregory A, Marijon, Eloi, Celermajer, David S, Jouven, Xavier
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 04-01-2018
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMc1714503

To the Editor:
Watkins et al. (Aug. 24 issue)
1
report that the health-related burden of rheumatic heart disease has declined worldwide. However, the authors emphasize mainly heart failure as the burden of rheumatic heart disease, whereas other complications were neglected. Patients with mild rheumatic heart disease that may not be clinically detectable are at increased risk for death and complications from other heart-related causes. For example, transient or sustained atrial fibrillation is sometimes observed in clinically asymptomatic patients with mild or moderate rheumatic mitral stenosis, which is often diagnosed on echocardiography after complications, such as stroke, have occurred.
2-4
Stroke, peripheral-artery . . .