What if it is the piston pins?

loud knocking internal lower part of engine usually means [ rod knock ] --bad wrist pin -spun bearing -or piston ring]s] --that the worst other can be timing failure --or component failure --you need to isolate the noise and diagnose from there

If its a knocking sound:

A KNOCKING SOUND IN THE ENGINE IS MOST LIKELY CAUSED BY ONE OF THE FOLLOWING
1. PISTON SLAP: Makes a sharp metallic noise. Idle engine and short out each cylinder plug. The noise will disappear when plug with bad piston is shorted. Noise will also disappear at acceleration. This can be caused by worn or out of round cylinder, or broken piston ring. Correct problem by re-boring cylinder and/or replacing piston.
2. VALVE NOISE: Makes clicking or rattle noise. Caused by excessive wear on valve stem or lifter, out of adjustment, or stuck valve. Correct by adjusting valve clearance, replace worn valve or lifter, regrind cam, replace valve guide and /or valve. A stuck valve can sometimes be loosened by passing oil through the carburetor while engine is running.

3. ROD BEARING KNOCK: Makes sharp metallic noise similar to a piston slap. Detection is opposite of piston slap. Rod knock is not heard at idle. Knock becomes louder as engine speed is increased. Caused by excessive rod bearing clearance. Correct by adjusting rod bearing clearance to .0015 inches by removing shims. May require re-pouring rod bearing.
4. REAR MAIN BEARING KNOCK: Makes dull knocking or thud noise. Detected at speeds between 20 and 50 MPH. Knock will normally decrease or disappear while pulling or decelerating. Noise will be detected the loudest at normal driving speed, when not pulling or decelerating. Correct by adjusting bearing clearance to .001 to .0015 inches. If knock is excessive, crank should be checked for out of roundness. May need to re-pour all main bearings to correct.
5. TIMING GEAR KNOCK: usually the most difficult to diagnose. If gear is loose or badly worn it will knock in all ranges. Run engine slightly above idle speed. Slowly open and close throttle. Knock will continue to be present, but just as engine slows down knock will become a slight rattle. Remove timing pin and reinsert into timing hole on timing gear cover. Press timing pin tightly against timing gear and accelerate slightly above idle. Knock will significantly be reduced or disappear. Correct by replacing both timing gear and crank gear as a matched set. The two gears should have a backlash clearance of .003 to .004. If more than .009 inch backlash, an oversize (.005) timing gear should be installed.
6. WRIST PIN SLAP: This can not be detected by shorting out the cylinder plugs. Rapidly accelerate and decelerate the engine speed. The engine will pass through a certain speed range when the wrist pin will rattle at about the same pitch as a valve tappet noise. This can be corrected by installing a new wrist pin bushing in the rod or new wrist pin f badly worn. Wrist pin should fit the piston and connecting rod with a tight metal to metal fit. The pin can be pushed into the piston and rod with a slight pressure of the hand. Pin to rod clearance is .0003 to .0005 inches.

TROUBLESHOOTING ENGINE NOISES
A KNOCKING SOUND IN THE ENGINE IS MOST LIKELY CAUSED BY ONE OF THE FOLLOWING
1. PISTON SLAP: Makes a sharp metallic noise. Idle engine and short out each cylinder plug. The noise will disappear when plug with bad piston is shorted. Noise will also disappear at acceleration. This can be caused by worn or out of round cylinder, or broken piston ring. Correct problem by re-boring cylinder and/or replacing piston.
2. VALVE NOISE: Makes clicking or rattle noise. Caused by excessive wear on valve stem or lifter, out of adjustment, or stuck valve. Correct by adjusting valve clearance, replace worn valve or lifter, regrind cam, replace valve guide and /or valve. A stuck valve can sometimes be loosened by passing oil through the carburetor while engine is running.

3. ROD BEARING KNOCK: Makes sharp metallic noise similar to a piston slap. Detection is opposite of piston slap. Rod knock is not heard at idle. Knock becomes louder as engine speed is increased. Caused by excessive rod bearing clearance. Correct by adjusting rod bearing clearance to .0015 inches by removing shims. May require re-pouring rod bearing.
4. REAR MAIN BEARING KNOCK: Makes dull knocking or thud noise. Detected at speeds between 20 and 50 MPH. Knock will normally decrease or disappear while pulling or decelerating. Noise will be detected the loudest at normal driving speed, when not pulling or decelerating. Correct by adjusting bearing clearance to .001 to .0015 inches. If knock is excessive, crank should be checked for out of roundness. May need to re-pour all main bearings to correct.
5. TIMING GEAR KNOCK: usually the most difficult to diagnose. If gear is loose or badly worn it will knock in all ranges. Run engine slightly above idle speed. Slowly open and close throttle. Knock will continue to be present, but just as engine slows down knock will become a slight rattle. Remove timing pin and reinsert into timing hole on timing gear cover. Press timing pin tightly against timing gear and accelerate slightly above idle. Knock will significantly be reduced or disappear. Correct by replacing both timing gear and crank gear as a matched set. The two gears should have a backlash clearance of .003 to .004. If more than .009 inch backlash, an oversize (.005) timing gear should be installed.
6. WRIST PIN SLAP: This can not be detected by shorting out the cylinder plugs. Rapidly accelerate and decelerate the engine speed. The engine will pass through a certain speed range when the wrist pin will rattle at about the same pitch as a valve tappet noise. This can be corrected by installing a new wrist pin bushing in the rod or new wrist pin f badly worn. Wrist pin should fit the piston and connecting rod with a tight metal to metal fit. The pin can be pushed into the piston and rod with a slight pressure of the hand. Pin to rod clearance is .0003 to .0005 inches.

A KNOCKING SOUND IN THE ENGINE IS MOST LIKELY CAUSED BY ONE OF THE FOLLOWING
1. PISTON SLAP: Makes a sharp metallic noise. Idle engine and short out each cylinder plug. The noise will disappear when plug with bad piston is shorted. Noise will also disappear at acceleration. This can be caused by worn or out of round cylinder, or broken piston ring. Correct problem by re-boring cylinder and/or replacing piston.
2. VALVE NOISE: Makes clicking or rattle noise. Caused by excessive wear on valve stem or lifter, out of adjustment, or stuck valve. Correct by adjusting valve clearance, replace worn valve or lifter, regrind cam, replace valve guide and /or valve. A stuck valve can sometimes be loosened by passing oil through the carburetor while engine is running.

3. ROD BEARING KNOCK: Makes sharp metallic noise similar to a piston slap. Detection is opposite of piston slap. Rod knock is not heard at idle. Knock becomes louder as engine speed is increased. Caused by excessive rod bearing clearance. Correct by adjusting rod bearing clearance to .0015 inches by removing shims. May require re-pouring rod bearing.
4. REAR MAIN BEARING KNOCK: Makes dull knocking or thud noise. Detected at speeds between 20 and 50 MPH. Knock will normally decrease or disappear while pulling or decelerating. Noise will be detected the loudest at normal driving speed, when not pulling or decelerating. Correct by adjusting bearing clearance to .001 to .0015 inches. If knock is excessive, crank should be checked for out of roundness. May need to re-pour all main bearings to correct.
5. TIMING GEAR KNOCK: usually the most difficult to diagnose. If gear is loose or badly worn it will knock in all ranges. Run engine slightly above idle speed. Slowly open and close throttle. Knock will continue to be present, but just as engine slows down knock will become a slight rattle. Remove timing pin and reinsert into timing hole on timing gear cover. Press timing pin tightly against timing gear and accelerate slightly above idle. Knock will significantly be reduced or disappear. Correct by replacing both timing gear and crank gear as a matched set. The two gears should have a backlash clearance of .003 to .004. If more than .009 inch backlash, an oversize (.005) timing gear should be installed.
6. WRIST PIN SLAP: This can not be detected by shorting out the cylinder plugs. Rapidly accelerate and decelerate the engine speed. The engine will pass through a certain speed range when the wrist pin will rattle at about the same pitch as a valve tappet noise. This can be corrected by installing a new wrist pin bushing in the rod or new wrist pin f badly worn. Wrist pin should fit the piston and connecting rod with a tight metal to metal fit. The pin can be pushed into the piston and rod with a slight pressure of the hand. Pin to rod clearance is .0003 to .0005 inches.

A KNOCKING SOUND IN THE ENGINE IS MOST LIKELY CAUSED BY ONE OF THE FOLLOWING
1. PISTON SLAP: Makes a sharp metallic noise. Idle engine and short out each cylinder plug. The noise will disappear when plug with bad piston is shorted. Noise will also disappear at acceleration. This can be caused by worn or out of round cylinder, or broken piston ring. Correct problem by re-boring cylinder and/or replacing piston.
2. VALVE NOISE: Makes clicking or rattle noise. Caused by excessive wear on valve stem or lifter, out of adjustment, or stuck valve. Correct by adjusting valve clearance, replace worn valve or lifter, regrind cam, replace valve guide and /or valve. A stuck valve can sometimes be loosened by passing oil through the carburetor while engine is running.

3. ROD BEARING KNOCK: Makes sharp metallic noise similar to a piston slap. Detection is opposite of piston slap. Rod knock is not heard at idle. Knock becomes louder as engine speed is increased. Caused by excessive rod bearing clearance. Correct by adjusting rod bearing clearance to .0015 inches by removing shims. May require re-pouring rod bearing.
4. REAR MAIN BEARING KNOCK: Makes dull knocking or thud noise. Detected at speeds between 20 and 50 MPH. Knock will normally decrease or disappear while pulling or decelerating. Noise will be detected the loudest at normal driving speed, when not pulling or decelerating. Correct by adjusting bearing clearance to .001 to .0015 inches. If knock is excessive, crank should be checked for out of roundness. May need to re-pour all main bearings to correct.
5. TIMING GEAR KNOCK: usually the most difficult to diagnose. If gear is loose or badly worn it will knock in all ranges. Run engine slightly above idle speed. Slowly open and close throttle. Knock will continue to be present, but just as engine slows down knock will become a slight rattle. Remove timing pin and reinsert into timing hole on timing gear cover. Press timing pin tightly against timing gear and accelerate slightly above idle. Knock will significantly be reduced or disappear. Correct by replacing both timing gear and crank gear as a matched set. The two gears should have a backlash clearance of .003 to .004. If more than .009 inch backlash, an oversize (.005) timing gear should be installed.
6. WRIST PIN SLAP: This can not be detected by shorting out the cylinder plugs. Rapidly accelerate and decelerate the engine speed. The engine will pass through a certain speed range when the wrist pin will rattle at about the same pitch as a valve tappet noise. This can be corrected by installing a new wrist pin bushing in the rod or new wrist pin f badly worn. Wrist pin should fit the piston and connecting rod with a tight metal to metal fit. The pin can be pushed into the piston and rod with a slight pressure of the hand. Pin to rod clearance is .0003 to .0005 inches.

Hello
Has the engine been run low on oil? Does the knocking get louder as the engine warms up? Have you had a automotive technician listen to this noise? Pistons don't really knock, the bearings in the engine called the crankshaft and piston connecting rod bearings do make a loud knocking noise, if that is the case the engine must be removed from the car and rebuilt.

Hello
Any knocking noise is more than likely due to worn connecting rod bearings, Crankshaft main bearings or piston or piston pin noise. Connecting rod bearing knocks and piston related noise quite some with warm up, piston noise tends to go completely away after about 5 minutes of run time, but there are exceptions to that run like a cracked piston skirt, crankshaft bearings don't quite very much. It would be my best quests without hearing the noise that you may have either a connecting rod or piston related noise. The best thing to do here is have a trained ear listen to the noise, any experienced technician will know very quickly what the noise is and where it is coming from. These types of noises are only common on high miles engines, with at least 100,000 miles on them is the general run or the engine has been run very low on oil repeated times, or the oil not changed at regular intervals or the engine has been severely overheated. My experience? 35 years as a dealer technican. I'm Master certified in all phases of auto and light truck repair.

loud knocking is usually a piston problem[wrist pin-piston-piston rings -rod bent damaged-crank -bearing ]piston hitting valve pull plugs and check for fouling it will narrow down area do compression test but knock usually doesnt last long before engine usually goes south other which u can hope for and can sound like a knock would be the exhaust gasket good luck

sound like an internal engine problem. either one or more of the pistons has "piston slap" and that knocking will diminish as the engine warms up or possibly a rod bearing is worn out. have a tech do a manual oil pressure test to make sure the oil pump and main bearings are ok. piston slap or knock that decreases when the engine warms up is not that serious, but a rod bearing knock or possible oil pump failure should be taken care of asap.

The knocking or ticking is going to determine if it is in the top end, lifters, push-rod or rocker arm issue or the bottom end that would include pistons or bearings.
If it is a ticking noise, it will more than likely be a valve train issue.
If a knocking noise, piston or crankshaft related problem.

Attached is a web site that you can listen to a piston slap which is a known issue for your 4.3.
Listen to the noise and see if it sounds similar to your problem. A piston slap will generally sound as though it is coming from the central area of the engine.
Listen to the recording and let me know.
Regards,