Pericardial rub

Pericardial friction rub

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, one systolic and two diastolic. It resembles the sound of squeaky leather and often is 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. The sound usually is best heard between the apex and sternum but may be widespread.


The pericardium is a double-walled sac around the heart. Pericarditis, or inflammation of the pericardium, causes the inner and outer (parietal and visceral) walls to rub against each other.

Differential diagnosis

Pericardial friction rub is one of several, similar sounds. A differential diagnosis may be possible, or not, depending upon the number of components that are audible. Pericardial friction rub may have one, two, or three audible components, whereas the similar pleural friction rub ordinarily has two audible components. One- and two-component rubs are ambiguous. A three-component rub distinguishes a pericardial rub and indicates the presence of pericarditis.

See also

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