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Introduction: COPD and CAD are common chronic diseases with shared risk factors. COPD continues to be largely underdiagnosed and undertreated. We aimed to describe the prevalence of COPD in Tunisian smokers with CAD Methods: In a cross-sectional study, patients over 35 years of age who underwent coronary angiography for suspected CAD and reported ≥10 pack-year of cigarette smoking were recruited. Spirometry was undertaken for all participants, and COPD was defined according to GOLD criteria. The finding of ≥50% coronary luminal narrowing confirmed the presence of CAD Results: Spirometry was undertaken for 122 men with mean age of 59.3 years and mean pack-year of 52.3. Mean CAD follow-up duration was 3.9 years. Diabetes, hypertension and dyslipidemia were the most common comorbidities. One or more threatening coronary lesions were found in 50% of patients. Echocardiography was normal in 45.9% of patients. The prevalence of COPD was 19.7%. Of the 24 patients with COPD,17 patients were newly diagnosed. Six patients had mild COPD,15 had moderate COPD,2 had severe COPD and 1 had very severe COPD. The mean FEV1 in COPD patients was 68.7%. COPD-related symptoms were:chronic cough(56%), dyspnea(76%) and wheezes(28%). Pulmonary arterial hypertension was observed in 36% of COPD patients. The comparison of patients with COPD with those without COPD showed that respiratory symptoms, chest-X-ray abnormality and pulmonary arterial hypertension were significantly more frequent in COPD patients Conclusion: There was a high prevalence of COPD among patients with CAD and most were underdiagnosed despite being symptomatic. Smokers with CAD and respi­ratory symptoms should be evaluated for airflow limitation

Background: Pleural effusions (PE) occur commonly after cardiac surgery (CS). However little is known about risk factors for their developing. Objective: the aim of our study was to investigate the prevalence, the clinical course and risk factors of PE after CS. Methods: It was a retrospective study from January 2011 to December 2016. We enumerate patients who developed pleural effusion after a CS and studied epidemiological clinical, biological and radiological data. Results: Among 75 patients included in the study, 31 patients(41%) developed a PE. The mean age was 57 years (28 males and 3 females). Seventeen patients were smokers. The Most common comorbidities were hypertension (55%), diabetes (55%).The most of these effusions occurred 15 days post surgery (early onset). The mean time of occurrence was by the seventh post operative day. PE were on the left side (51%), and bilateral (22%). The etiology of most of PE remains unclear. Eight of the effusions were a pneumonitis reaction, 3 were attributed to congestive heart failure and 1 was an empyema. Pleural fluid was hemorrhagic and fluid analysis showed an exudate in most cases. The volume of effusion was under 120 ml in 80% of patients. Coronary artery bypass grafting (CAPG) (71%) and valvular replacement (VR) (22%) were the most common indications for CS. The PE occurred in 40% of cases after a CAPG and in 14% of cases after a VR. The mean duration of CBP in patients who developed PE was 99,11min.The treatment was based on the etiology and pleural physiotherapy. The evolution was favorable in most cases. Conclusion: PE is common complication of CS. The cause of many of PE remains unclear. CAPG is associated with greater proportion of them.