24th May 2025

An 18-year-old girl is referred to you with worsening exertional dyspnoea over the last 5 months.

An 18-year-old girl is referred to you with worsening exertional dyspnoea over the last 5 months. On examination you note she has forceful pulsations stemming from her carotids. Auscultation of her chest revealed bilateral coarse crackles at the bases. Observations on triage are: BP 124/42 mmHg, HR84 bpm, SO2 95% on room air, RR25 and temperature of T 38.6 °C. She is usually fit and well, although her mother does recall her suffering from a particularly unpleasant sore throat episode approximately six months prior to the onset of her breathlessness. You also note annular erythema appearing as macules on her trunk. The outer edges are raised, and there is central clearing. 

As per the Jones criteria, which of the following are regarded as minor criteria for the diagnosis of rheumatic fever?

Select the SINGLE most appropriate option from the list below. Select ONE option only.