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A 13-year-old girl, refugee from Syria, presents for a routine medical examination. She has a history of rheumatic fever. She complains of mild shortness of breath when she exercises 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 she may contract infection in the school and would be dangerous for her. She misses her friends and wants to go back to school. Physical examination including cardiac and chest examination is normal. Lab tests are within normal limits except 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
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