Which finding is expected in a patient with suspected pericarditis?

• A. Friction rub heard at the lower left sternal border
• B. Chest pain worsened by exertion
• C. Shortness of breath with rest
• D. Palpitations without chest pain

Answer: (A)

Inflamed pericardial surfaces rub together, producing a friction rub on auscultation. This is a scratchy, high-pitched sound best heard at the lower left sternal border, especially when the patient leans forward and exhales. The presence of this rub is a classic clue pointing to pericarditis.

Chest pain in pericarditis is typically sharp and pleuritic, often relieved by sitting up and forward, and may be accompanied by relief with coughing or deep breaths—so pain worsened by exertion is less characteristic. Shortness of breath at rest can occur if there’s a larger effusion or tamponade risk, but it’s not as specific. Palpitations can occur in various conditions and aren’t as diagnostic for pericarditis.