Family Nurse Practitioner Exam

A patient presenting with a precordial rub is most likely diagnosed with?

1. Pulmonary embolism

2. Dissecting aneurysm

3. Pericarditis

4. Esophageal reflux

The correct answer is: Pericarditis

A precordial rub is most commonly associated with pericarditis, which is an inflammation of the pericardium, the fibrous sac surrounding the heart. When the pericardium is inflamed, the layers can produce a characteristic scratchy or squeaking sound as they rub against each other, particularly during heartbeats or while the patient breathes in. This friction rub is a key physical finding that helps in the diagnosis of pericarditis. In contrast, other options listed do not typically present with a precordial rub. For example, pulmonary embolism may present with chest pain, dyspnea, or hemoptysis but does not include a rub as a hallmark sign. A dissecting aneurysm generally causes severe, tearing chest pain that radiates to the back and may mimic other conditions but also lacks the characteristic rub. Lastly, esophageal reflux may cause chest discomfort that can be mistaken for cardiac pain but does not produce a precordial rub. This distinction emphasizes the specific nature of the rub in indicating pericarditis as the most likely diagnosis.