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Previous Volume 357:2088-2089 November 15, 2007 Number 20 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: Clinicians with access to echocardiography in regions in which rheumatic fever is endemic have been aware for decades that echocardiography is more sensitive and specific than auscultation in detecting acute carditis.^1,2,3 In New Zealand, an echocardiographic finding of left-sided regurgitation is accepted as evidence of carditis, and this has been formalized in recently published guidelines.⁴

On the basis of current knowledge, we agree with Dr. Marijon and colleagues (Aug. 2 issue)⁵ that morphologic valve changes, in addition to Doppler regurgitation, are necessary to define rheumatic heart disease in a setting in which most subjects are asymptomatic. More . . . [Full Text of this Article]

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