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 . . .

中文翻译：

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风湿性心脏病的全球负担

致编辑：沃特金斯等人。（8月24日发行）1报告说，风湿性心脏病的健康相关负担在全球范围内有所下降。但是，作者主要强调心力衰竭是风湿性心脏病的负担，而其他并发症则被忽略。患有轻度风湿性心脏病且可能无法在临床上检测到的患者，其死亡和其他与心脏相关的原因引起的并发症的风险增加。例如，在轻度或中度风湿性二尖瓣狭窄的临床无症状患者中有时会观察到短暂或持续的心房颤动，这通常在发生并发症（例如中风）后通过超声心动图进行诊断。2-4中风，外周动脉。。。