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Self-Assessment Questions


Answer 1
  1. Pericardial friction rub. A pericardial friction rub is detected in the majority of individuals with acute pericarditis. The presence of a pericardial friction rub is pathognomonic for pericarditis; however, its absence does not exclude the diagnosis. The sound typically has 3 components related to (1) atrial systole, (2) ventricular systole, and (3) ventricular diastole. The sound should be differentiated from a pleural rub, which although similar in quality (ie, a to-and-fro, superficially scratchy or squeaking sound), is timed with the respiratory cycle. A pericardial friction rub also must be differentiated from cardiac murmurs and artifactually produced friction of the stethoscope on the skin. Pericardial rubs may vary in intensity and may transiently disappear. Tachycardia, a low grade fever, leukocytosis, and an elevated erythrocyte sedimentation rate are all nonspecific markers associated with inflammation and provide no specific help in making the diagnosis of acute pericarditis.

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