الفهرس 
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Abstract
Acute rheumatic fever is a non-suppurative complication of group A beta-hemolytic streptococcal (GABHS) sore throat. It affects joints, skin, subcutaneous tissue, brain and heart. Except heart, all other effects are reversible. Cardiac complications are significant in absence of secondary prophylaxis and lead to chronic and life-threatening valvular heart disease. RF is considered as a social disease i.e. alteration in socio-economic state of a community will adversely or favorably affect the incidence of this disease.
RHD is a chronic disease caused by accumulated heart valve damage from a single severe or, more commonly, multiple recurrent ARF episodes. This means that, although RHD occurs in children, its prevalence peaks in adulthood, usually between the ages of 25 years and 45 years.
Screening survey was done on 5000 students in 16 primary and 8 preparatory schools in Aga town, Mansoura district, Dakahlia governorate.
Complete history taking, full clinical examination & investigations for suspected cases (ESR, ASOT, and CRP) were done. Those with any abnormality in history, clinical examination, positive family history of rheumatic heart disease or taking long-acting penicillin represented as a suspected group and were investigated by ECHO.
Forty-nine (49) children out of the 5000 children examined had abnormality in history taking or abnormal examination. 22 had arthralgia with long-acting penicillin use, 13 of them had tonsillitis with long-acting penicillin use, 2 had a family history of RHD and 12 of them had a murmur on auscultation. 13 students of the selected children refused to do Echo. The result of echo done was 5 cases had definite RHD, no borderline cases, 11 cases had mitral regurge not meeting criteria of RHD, one case had aortic regurge not meeting criteria of RHD, one had congenital heart disease in the form of VSD and the other 18 cases were normal.