Rheumatic fever is an immunologically mediated connective tissue disorder following throat infection with group-A streptococci (GAS). It is characterised by an inflammatory process involving collagen fibrils and the ground substance of the connective tissue. The primary sites of affliction are heart, joints and central nervous system. The salient clinical features are migratory polyarthritis, carditis, chorea and subcutaneous nodules. The saying is "it licks the joint but bites the heart in children and licks the heart and bites the joints in older patients". The most important sequelae of rheumatic fever is rheumatic valvular heart disease, which results in significant morbidity and mortality.