Pericardial effusion (PE) is a frequent finding in the setting of infective endocarditis and is widely believed to signify more advanced infective endocarditis (IE) and generally worst outcomes. Our study aimed to identify clinical characteristics and outcomes of patients who had pericardial effusion.

This was a prospective study which included all patients diagnosed with infective endocarditis (IE) and hospitalized in the cardiology department of Monastir hospital, Tunisia, between 1983 and 2017. We included patients who were diagnosed with definite infective endocarditis based on the modified Ducke criteria.

Three hundred forty patients were included in this study. The mean age of the patients was 37±17.92 years; 56.4% men and 33% had rheumatic heart disease. Pericardial effusion was observed in 6.35% of patients, most of them being mild or moderate (93.6%). Pericardial effusion was frequent in young patient. The presence of pericardial effusion was associated with a higher risk of heart failure during admission (60% vs. 32%, P=0.05). Patients with pericardial effusion had a higher rate of early surgery (23.3% vs. 3.6%; P=0.02) also. Despite these findings, the presence of pericardial effusion was not associated with a higher in-hospital or one-year mortality (16% vs. 21%; P=0.2 and 25% vs. 37.3%; P=0.70 respectively).

Pericardial Effusion was not an independent predictor of mortality. Its presence is associated with the development of heart failure during hospitalization, frequent surgery, probably reflecting indirectly mechanical complication.