One to three weeks after the preceding streptococcal infection, characteristic symptoms appear that are classified into “major criteria” and “minor criteria” according to Jones. The diagnosis of rheumatic fever can be made if two major criteria or one major and two minor criteria are present.
Jones criteria of the American Heart Association (AHA)
Major criteria (major criteria)
- Carditis (inflammation of the heart):
- Subacute endocarditis (endocarditis of the heart).
- Myocarditis (inflammation of the heart muscle)
- Pericarditis (inflammation of the pericardium)
- Migratory polyarthritis (Jaccoud arthritis) – inflammation of the large joints, with characteristic wandering of the often fleeting symptoms (in children and adolescents, the most common majorsymptomatology).
- Chorea minor (Sydenham) – involvement of the corpus striatum; almost only in children.
- Rheumatoid nodules (subcutaneous nodules) – under the skin on the extensor sides of the extremities.
- Erythema anulare rheumaticum (rheumatic erythema).
Minor criteria (secondary criteria)
- Fever
- Arthralgia (joint pain)
- ESR (erythrocyte sedimentation rate) and/or CRP (C-reactive protein) elevated.
- Prolonged PQ or PR time in the ECG.
- History of rheumatic fever or rheumatic valvular heart disease (medical history)
