Rheumatic heart disease is the most serious sequelae of rheumatic fever occurring in approximately 30% of rheumatic fever patients. Patients with acute rheumatic fever may develop varying degrees of pancarditis with associated valve disease, heart failure, and pericarditis. Worldwide, rheumatic heart disease remains a major health problem although its prevalence in the developed countries is much reduced. Involvement of the mitral valve results in mitral regurgitation and/or stenosis. Where surgery is indicated, mitral valve replacement is usually necessary although in some cases, mitral valve repair is possible.