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Pericardial Friction Rub
Aka: Pericardial Friction Rub
- Pathophysiology
- Pathognomonic for Pericarditis
- Occurs when heart rubs against pericardial sac
- Signs
- Three phase sound (classic triphasic sound in only 50% of cases)
- Atrial systole
- Ventricular systole
- Ventricular diastole
- Transient scratching sound
- Rasping sound of leather rubbing against leather
- Timing
- Transient - requires multiple attempts at auscultation
- Locations to best hear friction rub
- Apply stethoscope diaphragm to left lower sternal border
- Patient leaning forward
- At end of exhalation
- Differential Diagnosis
- Pleuritis
- Monophasic rub during respiration
- Efficacy
- Test Sensitivity: 85%
- Test Specificity: 100% for Acute Pericarditis
- References
- Spodick (1975) Am J Cardiol 35: 357-62 [PubMed]