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Q. What are the Signs used in acute pericarditis?

• Pericardial friction rub is pathognomonic of pericarditis. It is heard as a phasic scatching sound. It may vary with phases of respiration mostly increasing on inspiration. The pericardial rub is best audible in the lower left parasternal region. Classically pericardial rub has three components corresponding to ventricular systole, early ventricular diastole and atrial systole. Most often the pericardial rub is audible as a biphasic noise - a systolic and diastolic component. In 10 per cent of cases the pericardial rub is monophasic, during systolic phase only, when it can be confused with murmur. The pericardial rub most often waxes and wanes while this does not happen with murmur.

• Low grade to high grade fever can occur depending upon the etiology.

• Tachycardia is a feature of pericarditis.

• Patients are tachypnoeic and most often have shallow breathing secondary to painful restriction of inspiration.

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