Rheumatic heart disease is caused by rheumatism. Patients with rheumatic heart disease can have typical symptoms of rheumatism, but some people do not have a history of rheumatic disease. However, upon detailed inquiry, it may be considered that rheumatic fever exists. Rheumatic heart disease occurs when rheumatic fever affects the heart valves, often involving all the heart valves. The most commonly affected valves are the mitral and aortic valves. This can lead to adhesion, thickening, and stiffness of the valves, causing narrowing of the mitral valve along with regurgitation, and can also lead to combined valve disease, where mitral valve disease is accompanied by aortic valve disease. Clinical symptoms can present as episodes of heart failure and arrhythmias. Treatment requires mitral and/or aortic valve replacement surgery.