Friction rubs are extracardiac sounds of short duration that have a unique quality similar to the sound of scratching on sandpaper. Rubs may result from irritation of the pleura (i.e., a pleural rub) or of the pericardium (i.e., a pericardial rub). Pericardial rubs typically have three components: one systolic and two diastolic. The systolic component occurs during ejection;the two diastolic components occur during rapid filling and atrial contraction. Pericardial rubs are best heard with the patient sitting while holding breath in expiration. Patients with pericardial rubs commonly have chest pain that is lessened by sitting forward. A rub that disappears while the patient holds the breath originates from the pleura.
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