About Rheumatic Fever ?

Acutely, there's a pancarditis (endocarditis+myocarditis+pericarditis), and that's certainly reason enough for both congestive failure and dysrhythmias, but even more importantly, the attack on connective tissue tends to hit hard on the valves, with the mitral valve being damaged about two thirds of the time and the aortic valve a quarter of the time. Rheumatic fever was once perhaps the leading cause of valvular heart disease. Fortunately, it's become vanishingly rare in the major industrialized countries since penicillin became widely available.