A 13 year old girl presents for a routine medical examination. She has a history of rheumatic fever. She complains of mild shortness of breath when she run in gem class. She is absent of school for 3 weeks and her parents explain that she has multiple absentees because they are worried that they may contract infection in the school and would be dangerous for her. She missed her friends and want t go back to school. Her physical examination and lab tests are normal with slight increase in white blood cells. What is the most likely diagnosis of her condition? A- Mitral stenosis B- Exacerbation of Rheumatic fever C- Pulmonary artery stenosis D- Agoraphobia E- Vulnerable child syndrome http://medical-usmle.com/?p=572