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A pain of pericarditis, new onset murmur, pericardial friction rub and heart failure symptoms can be observed as initial ARF symptoms.
The classical picture as described in 1958 by Dressler (4) included chest pain, fever, fatigue, myalgia, arthralgia pericardial friction rub with effusion and pleuritis.
A triphasic pericardial friction rub is audible in approximately one-third of cases, best heard with the diaphragm of the stethoscope over the left lateral sternal border with the patient leaning forward (Audio 1).