Pericardial fremitus – palpable pericardial rub

Pericardial fremitus – palpable pericardial rub

A palpable pericardial rub is known as pericardial fremitus. It is due to the friction between the parietal and visceral layers of the pericardium. Some authors use the term as synonymous with pericardial rub [1,2].

The auscultatory counterpart of pericardial fremitus is the pericardial rub. Pericardial rub has a characteristic triphasic nature. The three phases of pericardial rub has been described as systolic, diastolic and atrial systolic. All the three components may not be audible always. Pericardial rub is known to be evanescent and requires careful auscultation for detection sometimes. In uremic pericarditis is usually quite loud and easily audible.


  1. Miltgen J et al. Two Cases of Pulmonary Tuberculosis Caused by Mycobacterium tuberculosis subsp. canetti. Emerg Infect Dis. 2002 Nov; 8(11): 1350–1352.
  2. Box CR et al. Statistics of Pericarditis with Effusion, from the London Hospitals (St. Thomas’s). Proc R Soc Med. 1910; 3(Med Sect): 104–109.



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