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Acute rheumatic fever presenting as unstable angina.

The most common presentation of acute rheumatic fever in adults is a febrile illness with an additive or migratory polyarthritis that is present on average in 92% of patients (range, 43–100%), or tenosynovitis usually of the wrists and ankles (67%). Carditis, present in 15 to 35% of patients, is usually mild and benign. We describe a case of an adult with acute rheumatic fever who presented with chest pain mimicking unstable angina. Fever developed only later in the course of his illness.