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A man with constrictive pericarditis had a high-pitched early diastolic sound on auscultation at the left lower sternal border, characteristic of a prominent pericardial knock. The high-pitched frequency distinguishes it from the low-pitched middiastolic rumble of an S3. A pericardial knock results from sudden cessation of rapid ventricular filling due to pericardial constraint and coincides with a y descent on jugular venous contour and a rapid diastolic filling wave in a ventricular tracing. See link below for complete details of the case.
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