What physical finding is most characteristic of pericarditis?

What physical finding is most characteristic of pericarditis?

• A. Pericardial friction rub
• B. S3 gallop
• C. Pulsus paradoxus
• D. Dullness to percussion

Answer: (A)

Pericardial friction rub is produced when inflamed pericardial surfaces rub together as the heart beats. This creates a distinct, high-pitched, scratchy or squeaky sound heard with the stethoscope, best at the left lower sternal border when the patient leans forward and during expiration. It directly reflects inflammation of the pericardium, making it the most characteristic physical finding of pericarditis. Other findings relate to different problems and are less specific. An S3 gallop signals volume overload or systolic dysfunction rather than pericardial inflammation. Pulsus paradoxus points toward tamponade or severe airway obstruction, not the typical presentation of uncomplicated pericarditis. Dullness to percussion suggests a pleural effusion or lung issue rather than pericardial inflammation alone.

Pericardial friction rub is produced when inflamed pericardial surfaces rub together as the heart beats. This creates a distinct, high-pitched, scratchy or squeaky sound heard with the stethoscope, best at the left lower sternal border when the patient leans forward and during expiration. It directly reflects inflammation of the pericardium, making it the most characteristic physical finding of pericarditis.

Other findings relate to different problems and are less specific. An S3 gallop signals volume overload or systolic dysfunction rather than pericardial inflammation. Pulsus paradoxus points toward tamponade or severe airway obstruction, not the typical presentation of uncomplicated pericarditis. Dullness to percussion suggests a pleural effusion or lung issue rather than pericardial inflammation alone.