History: A 10 year old Chinese girl presents with fever and joint swelling of 8 days duration.
Physical Examination: A thin underdeveloped female presents with a blood pressure of 122/68, heart rate is 86 bpm. She has a grade 3 harsh holosystolic murmur heard best at the apex of her heart. There is also a 2/6 early diastolic decrescendo murmur detected at the left sternal border. An S3 is present. The EKG demonstrates a 1st degree AV block. chest x-ray is normal.
The above symptoms would lead me to believe that the patient is suffering from acute rheumatic fever. This diagnosis of course is only based on the length of fever and whether the child had strep throat that was left untreated. Check out the video below for a more detailed explanation of rheumatic fever and how if left unchecked can lead to more complicated heart conditions.
