Rosa T Artola, Christos G Mihos, Orlando SantanaColumbia University Division of Cardiology at Mount Sinai Heart Institute, Miami Beach, FL, USAAbstract: Although the prevalence of rheumatic heart disease (RHD) has rapidly subsided over the last several decades in the United States, it still remains a serious cardiovascular disorder across the world, particularly in developing nations. Chronic autoimmune inflammation of the cardiac valves can result in mitral stenosis, increasing the risk of morbidity, mortality, and long-term sequelae in these patients. Researchers have begun to unravel the mysteries behind the development of RHD in the setting of chronic autoimmune inflammatory reactions and the roles genetic predisposition, antibody- and T-cell-mediated molecular mimicry, and cytokine proinflammatory responses play. In this article, the immunologic pathogenesis of RHD and its effects on the mitral valve are reviewed.Keywords: mitral stenosis, rheumatic heart disease, inflammation, cytokines