Pericardial friction rub

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Pericardial friction rub

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

The pericardial friction rub, also pericardial rub, is a sign on the precordial exam, detected by auscultation, that suggests irritation of the pericardium and the diagnosis of pericarditis. Inflammation of the pericardial sac causes the parietal and visceral surfaces of the roughened pericardium to rub against each other. This produces an extra cardiac sound of to-and-fro character with both systolic and diastolic components. One, two, or three components of a pericardial friction rub may be audible. A three-component rub indicates the presence of pericarditis and serves to distinguish a pericardial rub from a pleural friction rub, which ordinarily has two components. It resembles the sound of squeaky leather and is often described as grating, scratching, or rasping. The sound seems very close to the ear and may seem louder than or may even mask the other heart sounds. Friction rubs are usually best heard between the apex and sternum but may be widespread. The sound has three parts. Two diastolic, and one systolic.

Differential Diagnosis

In alphabetical order. [1] [2]

Diagnosis

History and Symptoms

  • History includes:
  • Family
  • Personal
  • exposures
  • recent viral exposure
  • fever
  • trauma


Below is the video demonstrating Pericardial friction rub:

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Laboratory Findings

  • Labs include:

Electrocardiogram

Chest X Ray

Echocardiography or Ultrasound

Treatment

  • Hemodynamic stability is intact
  • Supplemental oxygen

Acute Pharmacotherapies

Indications for Surgery

References

  1. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X


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