This is an example of acute pericarditis as auscultated at Erb's Point.

Murmurs are caused by turbulent blood flow across imcompetent or stenonic valves. In contrast, a pericardial friction rub is caused by the rubbing together of two surfaces of the pericardial sack.

The pericardial friction rub has three parts; a systolic component, an early diastolic component and a late diastolic component.

The first and second heart sounds are obscured by the rubbing sounds.

In the anatomy tab you can see the yellow fluid acumulation around the heart caused by an inflamed pericardial sack.