Our study in 131 patients showing sign of cardiac murmur investigated with echocardiography showed that chronic rheumatic endocarditis (CRE) is more aggressive especially in males in out population involying multiple values at a relatively younger age. Our findings further showed this mitral valve disease traditionally remains the commonest valve to be involved and absence of this should put serious doubts about the rheumatic a etiology. When involved alone, mitral stenosis (MS) rather than (MR) mitral regurgitation seems to be predominantly affecting the females, while MS occurring as part of multiple valvular pathology predominantly affects the male population.