Positive symptoms: symmetrical wandering pain of knees and wrists, fever and sore throat. Penicillin works.
Paroxysmal dyspnea at night, palpitation and shortness of breath.
Positive signs: congestion of pharynx, type I enlargement of tonsils, clear breathing sounds in both lungs, enlargement of heart boundary to the lower left, shoe-shaped percussion, and heart rate 100 beats/min. Heart rhythm, aortic valve auscultation soft sigh murmur, vascular examination heard gunshot and Duchenne murmur, depressed edema of both lower limbs.
4. Rheumatoid arthritis complicated with rheumatic heart disease and sinus rhythm with aortic insufficiency and cardiac function of 2-3 grades.