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pericardial friction rub
Etiology: pericarditis
Pathology:
- inflammation resulting in loss of lubricant allowing the 2 pericardial layers to slide against each other
Clinical manifestations:
1) synchronous with the heartbeat
2) may be inconsistent
3) positional changes may enhance of diminish the sounds
4) typically triphasic [2]
5) often described as creaking, grating, or scratching
6) best heard at the left sternal border with the patient sitting up, leaning forward, & holding the breath in expiration
7) pericardial rubs may vary in intensity with respiration [2]
8) also see friction rub
General
friction rub (friction fremitus)
References
- DeGowin & DeGowin's Diagnostic Examination, 6th edition,
RL DeGowin (ed), McGraw Hill, NY 1994, pg 340
- Medical Knowledge Self Assessment Program (MKSAP) 20
American College of Physicians, Philadelphia 2025