Acute pericarditis: pain and pericardial friction rub
THE CONTEXT
Acute pericarditis typically presents with characteristic chest pain, often accompanied by a low-grade fever. A pericardial friction rub is diagnostic.
Symptoms
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Pain location and radiation: Chest pain is retrosternal and radiates to the shoulders and neck.
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Pain aggravation: Deep breathing, movement, a change of position, exercise and swallowing typically worsen the pain.
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Fever: A low-grade fever is common.
Pericardial friction rub
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Character and mechanism: The rub is a high-pitched, superficial scratching or crunching noise produced by movement of the inflamed pericardium.
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Timing: It is usually heard in systole, may also be audible in diastole, and frequently has a ‘to-and-fro’ quality.
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Diagnostic significance: A pericardial friction rub is diagnostic of pericarditis.