Pericardial friction rub: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 13: Line 13:
   MeshID        = |
   MeshID        = |
}}
}}
{{SI}}
{{Pericarditis}}
{{CMG}}
{{CMG}}
{{Editor Help}}


==Overview==
==Overview==
The '''pericardial friction rub''', also '''pericardial rub''', is a [[Medical sign|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.
The '''pericardial friction rub''', also '''pericardial rub''', is a [[Medical sign|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 ==  
== Differential Diagnosis of Underlying Causes==  


In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
Line 31: Line 29:
*[[HIV]]
*[[HIV]]
*[[Ischemia]]
*[[Ischemia]]
*Leukemic infiltration
*[[Leukemic]] infiltration
*Mediastinal [[radiation]]
*Mediastinal [[radiation]]
*Mediastinal emphysema
*[[Mediastinal emphysema]]
*[[STEMI|Acute Myocardial Infarction]]
*[[STEMI|Myocardial Infarction]]
*[[Myocarditis]]
*[[Myocarditis]]
*[[Neoplasm]]
*[[Neoplasm]]
Line 54: Line 52:


=== History and Symptoms ===  
=== History and Symptoms ===  
*History includes:
History includes:
:*Family
*Recent viral exposure  
:*Personal
*[[Fever]]
:*exposures
*Trauma
:*recent viral exposure  
 
:*[[fever]]
===Physical Examination===
:*trauma
A careful exam should be conducted to evaluate the patient for signs of [[cardiac tamponade]].
*Exaggerated [[pulsus paradoxus]]




Line 82: Line 79:


=== Electrocardiogram ===  
=== Electrocardiogram ===  
*[[ECG]] for potential [[MI]], [[pericarditis]] or other cardiac problems
[[ECG]] for potential [[MI]], [[pericarditis]] or other cardiac problems


=== Chest X Ray ===  
=== Chest X Ray ===  
*[[Cardiomegaly]]
Depending upon the underlying cause and if an effusion is present, the chest x ray may show signs of [[cardiomegaly]]


=== Echocardiography or Ultrasound ===  
=== Echocardiography or Ultrasound ===  
Line 102: Line 99:


=== Indications for Surgery ===  
=== Indications for Surgery ===  
*Emergency [[pericardiocentesis]] to drain effusions of the [[pericardium]] in [[cardiac tamponade]]
An emergency [[pericardiocentesis]] is indicated in the presence of [[cardiac tamponade]], a large symptomatic [[pericardial effusion]], or to establish the diagnosis in a case of suspected malignant or tuberculous pericarditis.


==References==
==References==

Revision as of 14:52, 1 July 2011

Pericardial friction rub

Pericarditis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

HIV
Post MI
Dressler's syndrome
Post-pericardiotomy
Radiation
Tuberculosis
Uremia
Malignancy

Differentiating Pericarditis from other Diseases

Epidemiology and Demographics

Screening

Natural History, Complications and Prognosis

Pericardial Effusion
Cardiac Tamponade
Constrictive Pericarditis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Pericardiocentesis
Pericardial Window
Pericardial Stripping

Treatment Related Videos

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Pericardial friction rub On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Google Images

American Roentgen Ray Society Images of Pericardial friction rub

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pericardial friction rub

CDC on Pericardial friction rub

Pericardial friction rub in the news

Blogs on Pericardial friction rub

Directions to Hospitals Treating Type page name here

Risk calculators and risk factors for Pericardial friction rub

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

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 of Underlying Causes

In alphabetical order. [1] [2]

Diagnosis

History and Symptoms

History includes:

  • Recent viral exposure
  • Fever
  • Trauma

Physical Examination

A careful exam should be conducted to evaluate the patient for signs of cardiac tamponade.


Below is the video demonstrating Pericardial friction rub:

<youtube v=EUCp_3_vwtw/>


Laboratory Findings

  • Labs include:

Electrocardiogram

ECG for potential MI, pericarditis or other cardiac problems

Chest X Ray

Depending upon the underlying cause and if an effusion is present, the chest x ray may show signs of cardiomegaly

Echocardiography or Ultrasound

Treatment

  • Hemodynamic stability is intact
  • Supplemental oxygen

Acute Pharmacotherapies

Indications for Surgery

An emergency pericardiocentesis is indicated in the presence of cardiac tamponade, a large symptomatic pericardial effusion, or to establish the diagnosis in a case of suspected malignant or tuberculous pericarditis.

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


Template:SIB


Template:WikiDoc Sources

See also

Template:SIB

Template:WH Template:WS