Editing Pericarditis (section)

===Complications===
Pericarditis can progress to [[pericardial effusion]] and eventually [[cardiac tamponade]]. This can be seen in people who are experiencing the classic signs of pericarditis but then show signs of relief, and progress to show signs of cardiac tamponade which include decreased alertness and lethargy, [[pulsus paradoxus]] (decrease of at least 10 mmHg of the systolic blood pressure upon [[Inhalation|inspiration]]), low blood pressure (due to decreased [[cardiac index]]), (jugular vein distention from right sided [[heart failure]] and fluid overload), distant heart sounds on auscultation, and equilibration of all the diastolic blood pressures on cardiac catheterization due to the constriction of the pericardium by the fluid.{{citation needed|date=February 2021}}

In such cases of cardiac tamponade, [[Electrocardiogram|EKG]] or [[Holter monitor]] will then depict [[electrical alternans]] indicating wobbling of the heart in the fluid filled pericardium, and the [[capillary refill]] might decrease, as well as severe vascular collapse and [[altered mental status]] due to hypoperfusion of body organs by a heart that can not pump out blood effectively.{{citation needed|date=February 2021}}

The diagnosis of tamponade can be confirmed with [[Transthoracic echocardiogram|trans-thoracic echocardiography]] (TTE), which should show a large pericardial effusion and diastolic collapse of the right ventricle and right atrium. [[Chest X-ray]] usually shows an enlarged cardiac silhouette ("water bottle" appearance) and clear lungs. Pulmonary congestion is typically not seen because equalization of diastolic pressures constrains the pulmonary capillary wedge pressure to the intra-pericardial pressure (and all other diastolic pressures).{{citation needed|date=February 2021}}