Dr Das what u saw was that I enumerated signs as dds which is not. Let me explain all findings of Rhumatic fever donot present with "diagnosis written on their face". Inspite of long list of signs what u see are hardly' fleating joint pains" fever not respondind to usual assaults excluding salicylates whose response is almost diagnostic. Now the clinical presntatio are cardiac manifistations...sah an early diastollic murmer carry coombs) need to be differentiated fromother causes of diastolic murmers in general and early diastolic in perticular. The dd of distollic murmers range from fun- tional ( austin flints of A R) to organic murmers like A.R (early) , MS ( MID DISTOLIC WITH SYSTOLIC ACCENNUATION) TO SEAGUL MURMER OF SBE.TO SAY A FEW. LIKE WISE THE PROLINGED P.R INTERWAL , SBCUTANEOUS NODULES ETC THERE IS MUCH MRE THAN WHAT UR EYE MEETS IN MY POST...IF ONLY U CAN AC EPT..SIR.