<prompt> Not a feature of rheumatic hea disease -ChoreaAhritisJaneways lesionCarditis  <response>: 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 