Cardiac Question #20
The emergency department (ED) nurse is assessing a client who arrived with severe retrosternal chest pain described as burning and sharp which worsens on inspiration. The health care provider diagnoses the client with acute pericarditis. Which finding is most consistent with this diagnosis?
- Friction rub
- Fine crackles
- Coarse crackles
A pericardial friction rub a predominant finding in acute pericarditis and has a scratching, grating sound similar to leather rubbing against leather. Auscultation is best heard with the diaphragm of the stethoscope over the left lower sternal edge or apex during end expiration while the client is sitting up and leaning forward. Wheezes are high pitched and may be during inspiration or expiration and are caused by constriction or swelling of airway and are not diagnostic for acute pericarditis. Fine or coarse crackles are caused by fluid in small airways and are discontinuous sounds created by air forced through narrowed respiratory passages caused by fluid or mucus and are associated with infection or inflammation. Fine crackles are soft, high-pitched while coarse crackles are louder and lower in pitch.