Pericardial friction rub
Encyclopedia
A pericardial friction rub, also pericardial rub, is an audible medical sign
used in the diagnosis
of pericarditis
. Upon auscultation
, this sign is an extra heart sound of to-and-fro character, typically with three components, two systolic
and one diastolic
. It resembles the sound of squeaky leather and often is 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. The sound usually is best heard between the apex
and sternum but may be widespread.
is a double-walled sac around the heart
. The inner and outer (parietal and visceral) layers are normally lubricated by a small amount of pericardial fluid, but the inflammation
of pericardium causes the walls to rub against each other with audible friction.
may be possible, or not, depending upon the number of components that are audible. Pericardial friction rub may have one, two, or three audible components, whereas the similar pleural friction rub
ordinarily has two audible components. One- and two-component rubs are ambiguous. A three-component rub distinguishes a pericardial rub and indicates the presence of pericarditis.
Medical sign
A medical sign is an objective indication of some medical fact or characteristic that may be detected by a physician during a physical examination of a patient....
used in the diagnosis
Medical diagnosis
Medical diagnosis refers both to the process of attempting to determine or identify a possible disease or disorder , and to the opinion reached by this process...
of pericarditis
Pericarditis
Pericarditis is an inflammation of the pericardium . A characteristic chest pain is often present.The causes of pericarditis are varied, including viral infections of the pericardium, idiopathic causes, uremic pericarditis, bacterial infections of the precardium Pericarditis is an inflammation of...
. Upon auscultation
Auscultation
Auscultation is the term for listening to the internal sounds of the body, usually using a stethoscope...
, this sign is an extra heart sound of to-and-fro character, typically with three components, two systolic
Systole (medicine)
Systole is the contraction of the heart. Used alone, it usually means the contraction of the left ventricle.In all mammals, the heart has 4 chambers. The left and right ventricles pump together. The atria and ventricles pump in sequence...
and one diastolic
Diastole
Diastole is the period of time when the heart fills with blood after systole . Ventricular diastole is the period during which the ventricles are relaxing, while atrial diastole is the period during which the atria are relaxing...
. It resembles the sound of squeaky leather and often is 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. The sound usually is best heard between the apex
Apex of the heart
The apex of the heart is the lowest superficial part of the heart.It is directed downward, forward, and to the left, and is overlapped by the left lung and pleura.-External anatomy:...
and sternum but may be widespread.
Cause
The pericardiumPericardium
The pericardium is a double-walled sac that contains the heart and the roots of the great vessels.-Layers:...
is a double-walled sac around the heart
Heart
The heart is a myogenic muscular organ found in all animals with a circulatory system , that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...
. The inner and outer (parietal and visceral) layers are normally lubricated by a small amount of pericardial fluid, but the inflammation
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
of pericardium causes the walls to rub against each other with audible friction.
Differential diagnosis
Pericardial friction rub is one of several, similar sounds. A differential diagnosisDifferential diagnosis
A differential diagnosis is a systematic diagnostic method used to identify the presence of an entity where multiple alternatives are possible , and may also refer to any of the included candidate alternatives A differential diagnosis (sometimes abbreviated DDx, ddx, DD, D/Dx, or ΔΔ) is a...
may be possible, or not, depending upon the number of components that are audible. Pericardial friction rub may have one, two, or three audible components, whereas the similar pleural friction rub
Pleural friction rub
A pleural friction rub, or simply pleural rub, is a medical sign, audible by listening to the internal sounds of the body, usually using a stethoscope on the lungs, that is used in the diagnosis of pleurisy and other conditions affecting the chest cavity....
ordinarily has two audible components. One- and two-component rubs are ambiguous. A three-component rub distinguishes a pericardial rub and indicates the presence of pericarditis.