Physical exam-pericarditis and pericardial effusion

• Pericarditis: multiphasic friction rub best heard at LLSB w/ diaphragm of stethoscope. Notoriously variable and evanescent leathery sound w/ up to 3 components: atrial contraction, ventricular contraction, ventricular relaxation (NEJM 2012;367:e20).

• Effusion: distant heart sounds, dullness over left posterior lung field due to compressive atelectasis from pericardial effusion (Ewart’s sign)

• 心包炎： friction rub

• 帶聽診器隔膜的 LLSB 最好聽到多相摩擦摩擦。眾所周知的多變和消逝的皮革音，

  • 最多包含 3 個成分：心房收縮、心室收縮、心室舒張 (NEJM 2012;367:e20)。
  • three-component friction rub
  • An Audible Case of Acute Pericarditis | NEJM

• 積液：心音遙遠，左後肺野濁音，由於心包積液壓迫性肺不張（Ewart 徵）