- Pathognomonic for Pericarditis
- Occurs when heart rubs against pericardial sac
- Three phase sound (classic triphasic sound in only 50% of cases)
- Atrial systole
- Ventricular systole
- Ventricular diastole
- Transient scratching sound
- Rasping sound of leather rubbing against leather
- Timing
- Transient - requires multiple attempts at auscultation
- Locations to best hear friction rub
- Apply stethoscope diaphragm to left lower sternal border
- Patient leaning forward
- At end of exhalation
- Pleuritis
- Monophasic rub during respiration
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