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Rheumatic heart disease causes a substantial number of morbidity and mortality in Southeast Asia. In Bangladesh prevalence of Rheumatic Fever and Rheumatic heart disease is still high, 0.6 and 0.3 per thousand populations, respectively. Mitral valve mostly involved in the form of mitral stenosis in the rheumatic process. Treatment selections and its success largely depend upon the severity of disease especially the extent and distribution of calcification. Echocardiography has got the key role in determining the pattern, extent and severit