A case report of self-audible pericardial rub secondary to acute pericarditis from post-pericardiotomy syndrome (pericardial rub tinnitus)

BACKGROUND: Pericarditis is a common pericardial disorder that is frequently accompanied by a pericardial friction rub, which can be detected during a physical examination. Although patients’ awareness of cardiac murmurs and vascular bruits has been extensively reported, there are no reports on patients’ self-awareness of a pericardial friction rub. CASE SUMMARY: We present the first case of a patient with acute pericarditis associated with objective self-awareness of a pericardial friction rub, which we recorded with an electronic stethoscope and confirmed the sound with the patient. The patient had a recent history of three-vessel coronary artery bypass grafting and presented with a progressively worsening, rhythmic, and ‘sandpaper-scratching’ sound in both ears. The sound was more pronounced in the left lateral decubitus position. The symptom resolved with colchicine therapy and was associated with concomitant resolution of the pericardial friction rub. DISCUSSION: This is the first documented case of a patient demonstrating objective self-awareness of a pericardial rub resulting from acute pericarditis associated with post-pericardiotomy syndrome. Tinnitus refers to the perception of an auditory sensation that can be subjective or objective, depending on whether it is heard only by the individual or can also be heard by an observer. While objective tinnitus caused by cardiovascular conditions has been previously reported, no cases have attributed the pericardial friction rub as the underlying cause. Therefore, we suggest using the term pericardial rub tinnitus to describe this unique phenomenon.