Which auscultatory finding is most characteristic of pericarditis on exam?

Which auscultatory finding is most characteristic of pericarditis on exam?

• A. Pericardial friction rub
• B. S3 heart sound
• C. Murmur of aortic stenosis
• D. Mitral valve click

Answer: (C)

Pericarditis inflames the lining around the heart, so the most telling auscultatory finding is a pericardial friction rub. This is a high-pitched, scratchy or grating sound that results from the inflamed pericardial layers rubbing against each other as the heart beats. It’s best heard with the stethoscope placed at the left lower sternal border and often sounds louder when the patient leans forward, especially during expiration. The friction rub is considered the classic clue to pericarditis on exam because it directly reflects the irritated pericardial surfaces. The other options point to unrelated conditions. An S3 is a ventricular gallop associated with volume overload or reduced ventricular compliance, not pericardial inflammation. A murmur of aortic stenosis arises from a narrowed aortic valve, producing a systolic ejection murmur. A mitral valve click is typical of mitral valve prolapse. These findings don’t specifically indicate pericarditis.

Pericarditis inflames the lining around the heart, so the most telling auscultatory finding is a pericardial friction rub. This is a high-pitched, scratchy or grating sound that results from the inflamed pericardial layers rubbing against each other as the heart beats. It’s best heard with the stethoscope placed at the left lower sternal border and often sounds louder when the patient leans forward, especially during expiration. The friction rub is considered the classic clue to pericarditis on exam because it directly reflects the irritated pericardial surfaces.

The other options point to unrelated conditions. An S3 is a ventricular gallop associated with volume overload or reduced ventricular compliance, not pericardial inflammation. A murmur of aortic stenosis arises from a narrowed aortic valve, producing a systolic ejection murmur. A mitral valve click is typical of mitral valve prolapse. These findings don’t specifically indicate pericarditis.