How to differentiate pericardial Knock from S3?
- Pericardial knock – is a high-pitched early diastolic sound
- S3 is a low-pitched sound – Pericardial knock occurs earlier than an S3
What is the Mechanism of pericardial knock?
Mechanism of pericardial knock – high-pitched, early diastolic sound that occurs when unyielding pericardium results in sudden arrest of ventricular filling.
Pericardial knock can be an important clue to the diagnosis of constrictive pericarditis.
Pericardial knock – corresponds in timing to the
- abrupt cessation of ventricular expansion after AV valve opening
- prominent y descent seen in the jugular venous waveform in patients with constrictive pericarditis
How to differentiate pericardial Knock from S3?
- S3 is a low-pitched sound
- LV S3 – best heard over the LV apex with the patient in the left lateral decubitus position,
- RV S3 – best heard at the lower left sternal border or in the subxiphoid position with the patient supine and become louder with inspiration.
- Pericardial knock occurs earlier than an S3 heart sound which is the distinguishing factor
- S3 heart sound occurs from stretch of a very compliant left ventricle which takes a short time longer than Pericardial Knock.
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