心外膜表面可见粗糙的纤维蛋白渗出物。也是纤维素性心包炎。称为绒毛心。听诊时出现心包摩擦音，这是因为沉积在心外膜和心包的纤维素相互摩擦所致。
The epicardial surface of the heart shows a shaggy fibrinous exudate. This is another example of fibrinous pericarditis. This appearance has often been called a "bread and butter" pericarditis, but you would have to drop your buttered bread on the carpet to really get this effect. The fibrin often results in the the finding on physical examination of a "friction rub" as the strands of fibrin on epicardium and pericardium rub against each other.