Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Call emergency services if there is trouble breathing, choking, loss of consciousness, a seizure, or sudden weakness on one side.
Sudden one-sided weakness or speech loss may be a stroke rather than Sydenham chorea and needs emergency assessment.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Arrange a prompt medical assessment for new unexplained jerky movements, marked clumsiness, facial grimacing, or sudden changes in speech or walking.
Assessment is also important if these symptoms occur after a sore throat, skin infection, joint pain, fever, or previous rheumatic fever.
Seek urgent medical help if the person:
Cannot eat or drink safely because of movements
Has repeated falls or cannot walk safely
Develops new shortness of breath, chest pain, fainting, or a racing heartbeat
Has severe agitation, confusion, or a major change in awareness
3
Does any of this apply?
Book an appointment
Contact the healthcare team during routine follow-up if movements are becoming more disruptive, school or sleep is suffering, emotional symptoms are persistent, or preventive antibiotic doses have been missed.
Every sign above is quoted from the sofidex article on Sydenham chorea. If you are not sure, err upward — it is always reasonable to be checked.