I am a student of 2nd year in medical . my question is that, that how rheumatic heart disaese causes valvular heart disease?

Reference: "pathogenesis of acute rheumatic fever and rheumatic heart disease: evasive after half a century of clinical, epidemiological, and laboratory investigation" http://www.Ncbi.Nlm.Nih.Gov/pmc/articles/pmc1768618/.

Inflammation: Rheumatic fever is a systemic disease following strep pyogenes infection. Inflammation of the endocardium and valves lead to significant scarring, fibrosis and destruction of the valve structure and function leading to stenosis and/or regurgitation.

It is immunological: This is an immune complex deposition on the valves mainly the mitral valve . The m protein in the streptococcus and the myocardial tissue has cross reaction . The immune system attacks the strept bacteria as well as the myocardial tissue . The process trigger inflammation and destruction of tissues , scarring and redundancy . The commonest valvular abnormality is mitral stenosis