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Imtinene Ben Mrad,1 Melek Ben Mrad,2 Zeineb Oumaya,1 Ihsen Zairi,1 Boutheina Besbes,1 Khalil Ouaghlani,1 Sofien kamoun,1 Sobhi Mleyhi,2 Rim Miri,2 khadija Mzoughi,1 Sondos Kraiem1 1Cardiology Department, Habib Thameur Hospital, Tunis, Tunisia; 2Cardiovascular Surgery Department, Rabta Hospital, Tunis, TunisiaCorrespondence: Imtinene Ben MradCardiology Department, Habib Thameur Hospital, App 2b, Bloc 12, cite Olympique, Tunis, 1003, TunisiaTel +011 216 20156852Email imtinenebenmrad12@gmail.comAbstract: Alveolar hemorrhage (AH) is a heterogeneous clinical syndrome with a high mortality rate, characterized by extensive bleeding into the alveolar spaces. AH secondary to systemic thrombolysis treatment in the setting of acute myocardial infarction is an uncommon complication, but potentially fatal and can lead to acute respiratory failure. This entity is rarely reported in the literature. We report two cases of acute AH after intravenous thrombolysis for acute myocardial infarction, which could contribute to the literature on the subject, and discuss the risk factors as well as the clinical and radiological findings supporting the diagnosis. We overview also the rare previous published case reports in this context, and we contrast our findings with those reported in the literature.Keywords: hemoptysis, alveolar hemorrhage, myocardial infarction, fibrinolytic therapy, streptokinase

Imtinene Ben Mrad,1 Melek Ben Mrad,2 Bouthaina Besbes,1 Ihsen Zairi,1 Nofeil Ben Kahla,1 Sofien Kamoun,1 Khadija Mzoughi,1 Sondos Kraiem1 1Cardiology Department, Habib Thameur Hospital, Tunis, Tunisia; 2Cardiovascular Surgery Department, Rabta Hospital, Tunis, TunisiaCorrespondence: Imtinene Ben MradCardiology Department, Habib Thameur Hospital, App 2b, Bloc 12, cite Olympique, Tunis, 1003, TunisiaTel +216 20156852Email imtinenebenmrad12@gmail.comBackground: Behçet’s disease (BD) is a multisystemic vasculiti where cardiac involvement is not common. Previous studies have shown that the incidence of ventricular arrhythmia and sudden cardiac death (SCD) is higher in patients with BD than in the healthy population. Among various possible explanations, autonomic nervous system (ANS) dysfunction has been suggested. Few studies have evaluated ANS function in patients with BD, and the results obtained are controversial.Objective: We aimed to assess cardiac autonomic function by heart rate variability (HRV) in patients with BD; to evaluate circadian changes in HRV; and to study the relationship between HRV parameters and disease parameters.Methods: Thirty-six patients with Behçet’s disease (median age 42 years, 28 men) and 36 age- and sex-matched healthy volunteers were included. HRV analyses were performed in the time and frequency domains for the entire 24-hour period and for the daytime and nighttime periods. BD activity was studied with Behcet’s disease current activity form (BDCAF).Results: Patients with BD had significantly lower values of SDNN compared to controls. PNN50, RMSSD, and HF components mean values were significantly reduced in patients than in controls implying parasympathetic impairment. LF was comparable between the two groups, whereas LF/HF ratio was significantly higher in BD group. The circadian rhythm of HRV was preserved in patient group. There was no significant correlation of CRP or disease duration with HRV indices in Behçet’s subjects. BDCAF score was found to be negatively correlated with LF/HF.Conclusion: Patients with BD, despite no cardiovascular involvement, have reduced parasympathetic activity compared with controls. However, circadian rhythms of autonomic function were preserved. As known, there is strong evidence for the role of the ANS in the pathogenesis of ventricular arrhythmias. Thus, being a practical tool, HRV can be an interesting approach for the rhythmic follow-up of BD patients.Keywords: Behcet’s disease, autonomic nervous system, heart rate variability, disease activity

Imtinene Ben Mrad,1 Ramy Ben Salah,2 Melek Ben Mrad,3 Rim Miri,3 Anis Haddad,4 Sobhi Mleyhi,3 Ihsen Zairi,1 Khalil Hamza,5 Mariem Jrad,5 Raouf Denguir3 1Cardiology Department, Hbib Thameur Hospital, Tunis, Tunisia; 2Plastic Surgery Department, Bizerte Hospital, Tunis, Tunisia; 3Cardiovascular Surgery Department, Rabta Hospital, Tunis, Tunisia; 4General Surgery Department, Rabta Hospital, Tunis, Tunisia; 5Radiology Department, Charles Nicolle Hospital, Tunis, TunisiaCorrespondence: Melek Ben MradCardiovascular Surgery Department, Rabta Hospital, App 2b, Bloc 12, Cite Olympique, Tunis 1003, TunisiaTel +21655657116Email benmradmelek@yahoo.frAbstract: Aneurysms and pseudoaneurysms of the gluteal artery are rare. They represent less than 1% of the described arterial aneurysms. Those that touch the inferior gluteal artery are even rarer. Only a few cases have been described worldwide. Such cases often present with a variable time course, mode of injury, and associated symptoms, leading to their misdiagnosis and improper treatment. We present the case of a 30-year-old male, who presented to our emergency room one week after a stab wound in the left gluteal region causing a pseudoaneurysm of the left inferior gluteal artery with a sciatic compartment syndrome treated by a hybrid approach.Keywords: pseudoaneurysm, inferior gluteal artery, stab wound, embolization, sciatic nerve