Not a feature of rheumatic hea disease -

Acute rheumatic fever occurs most often in children; the principal clinical manifestation is carditis. Neveheless, about 20% of first attacks occur in adults, with ahritis being the predominant feature. Symptoms in all age groups typically begin 2 to 3 weeks after streptococcal infection, and are heralded by fever and migratory polyahritis-- one large joint after another becomes painful and swollen for a period of days, followed by spontaneous resolution with no residual disability. (1) carditis; (2) migratory polyahritis of large joints; (3) subcutaneous nodules; (4) erythema marginatum skin rashes; and (5) Sydenham chorea, (Robbins basic pathology,9th edition,pg no.392)