AssessmentsRheumatic heart disease
Rheumatic heart disease
USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 10-year-old girl comes to the clinic because of involuntary movement of her face and extremities for the past 2 weeks. Her mother mentions the patient was treated for a sore throat 2 months ago. Physical examination shows slurred speech, poor finger-to-nose coordination, and inability to clench her fists for prolonged periods. Oropharyngeal examination shows no abnormalities. Laboratory tests show elevated anti-streptolysin O. An echocardiogram shows mild mitral regurgitation and a thickened mitral valve. Which of the following is the most likely diagnosis?