Evolving Chest Pain in a Young Male Patient.

The ocular manifestations of RA such as episcleritis and scleritis are important to consider in this patient, as the bilateral conjunctival injection observed in this patient may reflect an underlying systemic inflammatory process. Although the patient was at a low risk for developing ARF, as it is significantly less common in the US than underdeveloped countries, the presence of clinical carditis, polyarthralgia, fever of >=38.5°C, and significantly elevated markers of inflammation are sufficient to fulfill the 2015 Jones criteria for rheumatic fever and support the diagnosis of ARF in this patient. The angiographic findings suggestive of coronary vasculitis, and biopsy-proven vasculitis of small to medium-sized testicular arteries led to the specific diagnosis of PAN, which enabled the patient to receive the appropriate treatment for his underlying disease. [Extracted from the article]