What does a pericardial friction rub indicate?
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.
What conditions may a pericardial friction rub occur with?
Rubs: Pericardial friction rubs usually occur in the setting of pericarditis. They are caused by friction between the inflamed pericardial surfaces. It is a rocking to-and-fro sound that resembles walking in fresh snow. It is more pronounced with the patient leaning forward.
Where is pericardial friction rub best heard?
15,16 The pericardial rub is best auscultated with the diaphragm of the stethoscope over the left lower sternal border in end expiration with the patient leaning forward. It has a rasping or creaking sound similar to leather rubbing against leather.
What are the features of pericardial rub?
A pericardial friction rub is pathognomonic for acute pericarditis; the rub has a scratching, grating sound similar to leather rubbing against leather. Serial examinations may be necessary for detection, as a friction rub may be transient from one hour to the next and is present in approximately 50% of cases.
How does the nurse differentiate a pleural friction rub from a pericardial friction rub?
How does the nurse differentiate a pleural friction rub from a pericardial friction rub? Pericardial friction rubs can be differentiated from pleural friction rubs by having the client hold the breath. If present without breathing, the rub is pericardial.
How is pericardial friction rub diagnosis?
Auscultation with the diaphragm of the stethoscope over the left lower sternal edge or apex during end expiration with the patient sitting up and leaning forward (or on hands and knees) allows the best detection of the rub and increases the likelihood of observing this finding.
Where do you listen for pleural friction rub?
It can be noticed by listening to the internal sounds of the body, usually using a stethoscope on the lungs. These are the squeaking or grating sounds of the pleural linings rubbing together. It is best described as the sound made by treading on fresh snow.
What are Crepitation sounds?
Crepitation refers to situations where noises are produced by the rubbing of parts one against the other, as in: Crepitus, a crunching sensation felt in certain medical problems. Rales or crackles, abnormal sounds heard over the lungs with a stethoscope. A mechanism of sound production in grasshoppers during flight.
Which characteristic would the nurse expect to hear in a patient with a pleural friction rub?
On auscultation, pleural friction rub is a non-musical, short explosive sound, described as creaking or grating, and likened to walking on fresh snow. The sound may be intermittent or continuous.
What is a rub heart sound?
A pericardial friction rub is caused by movement of inflammatory adhesions between visceral and parietal pericardial layers. It is a high-pitched or squeaking sound; it may be systolic, diastolic and systolic, or triphasic (when atrial contraction accentuates the diastolic component during late diastole).
How do you treat pleural rubs?
Pleural friction rub treatment
- If the pleural friction rub is caused by a bacterial infection, your healthcare provider might prescribe antibiotics for the infection.
- Your healthcare provider may recommend nonsteroidal anti-inflammatory drugs like ibuprofen to help manage inflammation.
What are pericardial friction rubs?
Pericardial friction rubs are extra sounds created by the rubbing together of the parietal and visceral pericardial layers. In normal animals, the movement of these layers is inaudible. When the layers are inflamed, they no longer interact smoothly and friction is created.
What is a triphasic pericardial rub?
In most cases, the rub is triphasic (audible in atrial, ventricular systole, and ventricular diastole phases) and is of high frequency. A pericardial rub is highly specific for acute pericarditis.
What does a pericardial rub sound like?
A pericardial rub is highly specific for acute pericarditis. It is generally heard over the left sternal border, it is often louder at inspiration but sometimes can be better heard on forced expiration while the patient bends forward.
What does the presence of pericardial rub post mi indicate?
Presence of pericardial rub post MI indicate a transmural involvement or atleast significant epicardial involvement. Recognition of this is important as presence of pericardial rub increases the risk of rupture and hemorrhagic effusion if anticoagulants are used. What is the relationship between pericardial effusion and pericardial rub?