Complex arrhythmias in the absence of severe valvulitis: a paediatric case of acute rheumatic fever

A 15-year-old boy was admitted to the emergency department with arthralgia of the knee. He was diagnosed with acute rheumatic fever based on clinical examination, electrocardiography, echocardiography, and elevated inflammatory markers including C-reactive protein, erythrocyte sedimentation rate, and anti-streptolysin O titre. First-degree and second-degree Mobitz type 1 atrioventricular blocks, moderate frequency uniform ventricular premature beats, as well as non-sustained ventricular tachycardia, were detected on 24-hour Holter electrocardiography monitoring.