JONES criteria mnemonic for diagnosis of rheumatic heart disease (RHD)





Acute rheumatic fever

1.  Uncommon sequela of untreated group A streptococcus infection.

 2.  Streptococcus infection can provoke autoantibodies that attack joints and heart valves (mitral > aortic > tricuspid).


 3.  Incidence is low in the United States because of antibiotic treatment.

 4.  The term “rheumatic heart disease” describes both the acute carditis (pericarditis, myocarditis, valvulitis) and chronic valvular damage.


 5.  Migratory arthritis, hot and swollen joints, fever, subcutaneous nodules on extensor surfaces, Sydenham chorea (i.e., purposeless involuntary movement), erythema marginatum (i.e., painless rash).

 6.  Diagnosis made using Jones criteria.

 7.  Labs:  increased erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and white blood cell (WBC) count; 90% of patients have antistreptococcal antibodies.

 8.  ECG:  increased PR interval.

 9.  Treatment: NSAIDs for joint inflammation; use corticosteroids, if carditis is severe; b-lactam (penicillin family) antibiotic for infection.

 10.  Complications: progressive valve damage if untreated.

 JONES criteria mnemonic for diagnosis of rheumatic heart disease (RHD):




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