<s>[INST] context: Symptoms Rheumatic fever symptoms vary. You can have few symptoms or several, and symptoms can change during the course of the disease. The onset of rheumatic fever usually occurs about two to four weeks after a strep throat infection. Rheumatic fever signs and symptoms -- which result from inflammation in the hea, joints, skin or central nervous system -- can include: Fever Painful and tender joints -- most often in the knees, ankles, elbows and wrists Pain in one joint that migrates to another joint Red, hot or swollen joints Small, painless bumps beneath the skin Chest pain Hea murmur Fatigue Flat or slightly raised, painless rash with a ragged edge Jerky, uncontrollable body movements (Sydenham chorea) -- most often in the hands, feet and face Outbursts of unusual behavior, such as crying or inappropriate laughing, that accompanies Sydenham chorea Complications Inflammation caused by rheumatic fever can last a few weeks to several months. In some cases, the inflammation causes long-term complications. Rheumatic fever can cause permanent damage to the hea (rheumatic hea disease). It usually occurs 10 to 20 years after the original illness, but severe cases of rheumatic fever can cause damage to the hea valves while your child still has symptoms. Problems are most common with the valve between the two left chambers of the hea (mitral valve), but the other valves can be affected. The damage can result in: Narrowing of the valve. This decreases blood flow. Leak in the valve. A leaky valve causes blood to flow in the wrong direction. Damage to hea muscle. The inflammation associated with rheumatic fever can weaken the hea muscle, affecting its ability to pump. Damage to the mitral valve, other hea valves or other hea tissues can cause problems with the hea later in life. Resulting conditions can include: An irregular and chaotic heabeat (atrial fibrillation) Hea failure ref : harrisons 21st ed [/INST] question: An 60 yr old unvaccinated came to the OPD with fever and red eyes O/e the following type of rash was seen body of the pt . What is the most likely complication expected with this condition | options: A: myocarditis B: nephritis C: pancreatitis D: orchitis | answer: A </s>