RESUMEN
Acute rheumatic fever has a world-wide distribution and continue to be a major cause of heart disease. Rheumatic fever results from group A beta hemolytic streptococcal infection of throat and tonsils in 3% of cases.Valvular lesions results from rheumatic heart disease which causes disability or death [1.8%]. This survery was carried out on 1000 cases in Samalout. Minia Governorate, 400 from out-patient clinic in samalout.Hospital [212 males and 188 females and 600 cases from primary schools in rural areas [350 males and 250 females]. Their ages ranged from 4 to 28 years. Swabs were taken from all cases and inoculated on blood agar plates and incubated at 37°C for 24 hours. Films were prepared stained with gram stain and examined microscopically. Full investigations were done to positive cases for beta hemolytic streptococci. Mean age of rheumatic heart affection was 16.33 years. Females are more affected than males [55.55%]. The mitral valve was the commonly affected valve [72%], next came the aortic and tricuspid valves. Pulmonary valve did not show any rheumatic lesion. There was a good relation between throat infection with streptococci and rheumatic heart; as well elevated ESR was found in 72%. High levels of ASO titre was detected in all cases of rheumatic heart diseases