Pericardial Friction Murmur

Pericardial friction rub (PRR) is a sound that occurs when the visceral and parietal layers of the pericardium rub against each other as the heart structure vibrates. The sound signal is typical for patients with non-rheumatic heart pathology, less often - in patients with rheumatic heart disease or atrial murmurs. The condition is also recorded with ischemic changes in the myocardium. Some researchers are reluctant to include PTS in Parkinson-Murphy syndrome; on the contrary, the second name of the syndrome is “the heart makes a sound like a glove.” The opinions of doctors are conventionally divided between two camps: in one group, pathology is diagnosed in the presence of murmurs in the cavities of the heart, and in the second - in their absence. At the same time, all similar sounds from the side of the sternum, created and disappearing along with systole and diastole, should be taken as noise. If they are not directly related to cardiac activity, then they are classified as functional murmurs. Among them we can distinguish neurocardiac, myocardiogenic, and foreign bodies. “Wet” type murmurs are formed due to looseness of the falciform ligament and diffuse cardiomyopathies. They are represented by a variety of synchronous signals, characterized by amplitude moderation and rhythmic modulation. The left side of the chest is considered dominant - above the pulmonary trunk. The signal is combined with an increase in cardiac output, becomes prolonged, accentuates the jugular notch from below, and resembles the sound of damage to the valve structures. The sound of a “dry” character is the result of vibrations from large vessels. Due to increased vascular permeability, the Kallistov or Flinders noise phenomenon is formed. Cholesterol plaque, mineral deposits, and calcification of pericardial structures also lead to ringing when pressed. There is a congenital pathology - enostosis, which occurs with a systolic sound (clinically - Morgagni syndrome) or a diastolic murmur due to swelling of the thoracic lymph node. Pericardial friction noise on the left with blockage