H Ammar

Publications (19)14.1 Total impact

• Article: [Hydatid cyst of the right atrium].

  H Bouraoui, B Trimech, A Madhaoui, S Ernez-Hajri, G Jeridi, H Ammar
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  ABSTRACT: Cardiac hydatid cysts are rare; the right atrial location is even rarer and carries serious complications. We report three cases of cardiac hydatid cyst of the right atrium. The first patient died in the postoperative period due to right heart failure and massive tracheal bleeding. The course of the disease of the two other patients was uneventful. Echocardiography is the most informative technique for identifying and localising the cyst before surgery. Right atrium hydatid cyst should be treated by early surgical excision with a view to prevent the risk of pulmonary embolism.
  Revue médicale de Liège 02/2006; 61(1):8-10.
• Article: [Impact of diabetes on mortality after myocardial infarction].

  H Bouraoui, B Trimeche, S Ernez-Hajri, A Mahdhaoui, J Zaaraoui, A Gasmi, G Jeridi, H Ammar
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  ABSTRACT: Myocardial infarction is a common cause of mortality in people with diabetes. The aim of this study was to determine early and mid-term mortality in diabetic patients with myocardial infarction and to determine if hyperglycemia was predictor of mortality. We conducted a retrospective study of 100 diabetic patients compared with 100 non diabetic patients who were hospitalised in our institution between 1999 and 2003 for myocardial infarction. RESULTS: Hospital and one year mortality were highest among diabetic patients compared with non diabetic patients. Multivariate analysis showed that admission plasma glucose was a consistent predictor factor of in hospital mortality RR 1.2 (IC 1.02-1.47). Admission plasma glucose was significantly higher in nonsurvivors diabetic patients than in survivors (22.7 vs 16 mmol/l P = 0.04). The predictor factors of one year mortality was age, female sex and no beta blocker at discharge RR5.3 (1.9-14.3). CONCLUSION: Diabetic patients with myocardial infarction have poor prognosis and hyperglycemia was associated with in hospital mortality.
  Annales de Cardiologie et d Angéiologie 04/2005; 54(2):55-9. · 0.28 Impact Factor
• Article: [Prosthetic valve endocarditis due to Enterobacter aerogenes].

  H Bouraoui, B Trimeche, N Kaabia, J Zaaraoui, A Mahdhaoui, S Ernez-Hajri, G Jeridi, H Ammar
  La Revue de Médecine Interne 02/2005; 26(1):71-2. · 0.61 Impact Factor
• Article: [Prognosis of periprosthetic regurgitation after mitral valve replacement using the Saint Jude prosthesis].

  A Mahdhaoui, M A Majdoub, H Bouraoui, N Tlili, S Ernez-Hajri, G Jeridi, J Zaaraoui, H Ammar
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  ABSTRACT: Periprosthetic regurgitation (PPR) is a common complication of mitral valve replacement (MVR). The management of moderate and minor PPR remains controversial. The goal of this prospective study was to determine the incidence, predictors and outcome of PPR discovered using omniplan transoesophageal echocardiography (TEE) performed at the early postoperative period (14.7 days) of MVR with SJM prosthesis. Our study enrolled 56 patients, the mean age was 44.5 +/- 11.9 years. The incidence of PPR was 59% (33 patients). TEE showed one jet in nine patients (27%), two jets in 23 patients (70%) and three jets in one patient (3%). PPR is minor in 24 patients (63%) and moderate in nine patients (27%). No patient developed hemolytic anemia or congestive heart failure. In univariate analysis, diameter of prostheses > 27 mm, number of suture knots < 17 and diameter of prostheses/number of knot ratio > 1.7 independently predicted the presence of PPR. In multivariate analysis only a rapport diameter of protheses/number of suture knots > 1.7 mm is predictif of PPR (odd ratio = 9, P = 0.036). Ninety percent of PPR remained present at six weeks and only 29% were present after 12.5 months. CONCLUSION: Mild and minor PPR were frequent during the early postoperative period after MVR. The clinical significance and natural history is benign and they do not require any specific treatment.
  Annales de Cardiologie et d Angéiologie 03/2004; 53(2):61-5. · 0.28 Impact Factor
• Article: [Double location of cardiac hydatid cyst: left ventricle and pulmonary artery].

  A Mahdhaoui, H Bouraoui, J Souissi, K H Mabrouk, F Bahri, H Amara, S Ernez-Hajri, G Jeridi, H Ammar
  La Revue de Médecine Interne 02/2004; 25(1):94-6. · 0.61 Impact Factor
• Article: [Evaluation of the hemodynamic profile of mitral Saint Jude Medical prostheses in the early and late postoperative period].

  A Mahdhaoui, M A Majdoub, H Bouraoui, S Ernez Hajri, G Jeridi, B Trimeche, J Zaaraoui, H Ammar
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  ABSTRACT: This study was to estimate the Doppler haemodynamic profiles of 56 prosthetic mitral valves (St Jude prosthesis) in the premature post-operating period, to study the correlation of the prosthetic area calculated by Doppler method (continuity equation (CE) and pressure half times (PHT)) and the area of the effective orifice in the post-operating premature period, in 6 weeks and after 6 months. The values of peak gradient and mean gradient at six week and at 12.5 months were not significantly different from those obtained in the premature exam. The prosthetic area calculated by continuity equation (ACE) in the premature postoperative period was significantly different between the various size (p = 0.0001). The (ACE) measured at 6 weeks and late (12.5 months), was not significantly different from that calculated in the premature exam (respectively p = 0.79 and p = 0.8). The (PHT) was very variable even within the different size of the prosthesis, however values measured at six weeks and in the late exam was not different from that calculated in the premature exam. In absence of complications, it seems to us that we can satisfy with using as reference exam data obtained in the premature exam.
  Archives des maladies du coeur et des vaisseaux 11/2003; 96(10):977-83. · 0.40 Impact Factor
• Article: Hydatid cyst of the right atrium and rheumatic mitral disease: a fortuitous association.

  A Mahdhaoui, H Bouraoui, A Khelif, M A Majdoub, G Jeridi, S Ernez Hajri, J Zaaraoui, H Ammar
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  ABSTRACT: Ecchinococcal infestation of the heart accounts for only 0.5-2% of ecchinococcosis cases. A case is reported of right atrial hydatid cyst associated with rheumatic mitral valve disease in a 43-year-old woman. Physical examination and chest X-radiography revealed mitral disease. Transthoracic and transesophageal echocardiography demonstrated a single, large cystic mass of 4 x 4 cm located in the right atrium, and heavily calcified mitral rheumatic disease with commissural fusion. Confirmatory computed tomography and magnetic resonance imaging excluded other extracardiac locations. Radioisotopic lung perfusion scanning and angiographic scanning excluded pulmonary embolism. The patient underwent mitral valve replacement and the hydatid cyst was excised. An intraoperative examination and subsequent pathology confirmed a diagnosis of hydatid cyst.
  The Journal of heart valve disease 08/2003; 12(4):535-7. · 0.81 Impact Factor
• Article: [Delays in the management of AMI: Results of an investigation conducted in Sousse (Tunisia)].

  A Mahdhaoui, H Bouraoui, M A Majdoub, A Ben Abdelaziz, B Trimeche, J Zaaraoui, G Jeridi, S Ernez Hajri, H Ammar
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  ABSTRACT: The goal of our work was to assess the delays of admission for Acute Myocardial Infarction (AMI) in Sousse (Tunisia) and to identify predictors of these delays. Our prospective survey was led from January 1999 to December 2001; 232 patients with AMI were included. The onset of symptoms usually occurred in the patient's home (80.6%). The chest pain was atypical in 19.4% of cases; 91% of patients directly consulted the emergency departments, whereas the ambulatory emergency services were used in only in 2.2% of cases. Delays of hospitalization in coronary care units were on average too long (14 h 21 min +/- 19 h 16 min). This prolongation was essentially caused by a too long period between onset of symptoms and first patient call. In bivariate analysis, dyslipidemia, diabetes, absence of smoking and an atypical symptoms were associated with prolonged hospitalization delays. However in multivariate analysis, only diabetes and atypical symptoms were independent factors associated with a hospitalization delay of more than 12 h. In 23% of the patients, a prolonged pre-hospital time period prevented the use of thrombolysis. CONCLUSION: Pre-hospital delays should be shortened by a multidisciplinary action that especially focuses on a better sanitary education of patients to risk.
  Annales de Cardiologie et d Angéiologie 03/2003; 52(1):15-9. · 0.28 Impact Factor
• Article: [Myocardial infarction and abnormal origin of the circumflex coronary artery].

  A Mahdhaoui, H Bouraoui, M E Majdoub, S Ernez-Hajri, G Jeridi, E Boughzela, H Ammar
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  ABSTRACT: Abnormal origin of the circumflex coronary artery without any stenosis is generally considered benign and without any particular ischemic risk. We report a case of a 21 year old man who suffered a posterior lateral myocardial infarction with objective criteria: electrocardiographic, echocardiographic and isotopic. The patient received thrombolytic therapy at H2. Angiography showed an abnormal origin of the circumflex coronary artery which was free of any stenosis. Certain cases of the circumflex artery anomaly can, therefore, be complicated by myocardial infarction, and the benign nature of the anomaly needs to be re-examined.
  Annales de Cardiologie et d Angéiologie 01/2003; 51(6):373-6. · 0.28 Impact Factor
• Article: [Familial hypertrophic cardiomyopathy associated with Wolff-Parkinson-White syndrome revealing type II glycogenosis].

  B Tabarki, A Mahdhaoui, M Yacoub, H Selmi, N Mahdhaoui, H Bouraoui, S Ernez, G Jridi, H Ammar, A S Essoussi
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  ABSTRACT: Symptoms of the late infantile form of type II glycogen storage disease are mainly due to functional impairment of skeletal muscle. Cardiac muscle can be involved in the late stage of the disease. CASE REPORT: We report the cases of two siblings seven and 12 years old with type II glycogen storage disease. The initial symptoms were hypertrophic cardiomyopathy with Wolf-Parkinson-White syndrome. CONCLUSION: Hypertrophic cardiomyopathy may be the form of presentation of the late infantile form of type II glycogen storage disease. The risk of sudden death is high.
  Archives de Pédiatrie 08/2002; 9(7):697-700. · 0.30 Impact Factor
• Article: [Cardiovascular risk in schoolchildren in rural Sousse, Tunisia].

  H Ghannem, I Harrabi, A Ben Abdelaziz, R Gaha, L Trabelsi, H Selmi, G Jeridi, H Ammar, A S Essoussi
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  ABSTRACT: There is no data available on the cardiovascular risk of children under 18 years of age in Tunisia, although it is well known that these risk factors present themselves in childhood. The authors performed an epidemiological study based on a representative sample of 793 schoolchildren in the rural region of Sousse, in Tunisia, to determine the incidence of the following risk factors: hypertension, hypercholesterolaemia and other lipid disorders, obesity and smoking. The main results show that the prevalence of hypertension is 11.2% with no statistically significant difference between the sexes. The prevalence of hypercholesterolaemia (2.9%), of hyper-LDL cholesterolaemia (0.6%) and hypertriglyceridaemia (1%) were comparable in boys and girls. Obesity (BMI > 30) was observed in 1.8% of the study population and was as common in girls (1.7%) as in boys (1.9%). Smoking was recorded in 4% of the study population and was commoner in boys (7.3%) than in girls (1.2%). This cardiovascular risk profile is encouraging and efforts should be made to maintain these levels until adulthood. This data will form the basis of a regional programme for the promotion of cardiovascular health in schools.
  Archives des maladies du coeur et des vaisseaux 12/2001; 94(12):1381-5. · 0.40 Impact Factor
• Article: [The role of Doppler echocardiography in chronic constrictive pericarditis].

  A Mahdhaoui, H Bouraoui, S Ernez-Hajri, G Jeridi, A Saadaoui, H Ammar
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  ABSTRACT: Constrictive péricarditis (CCP) is a rare but serious disease. It still poses diagnostic difficulties. The purpose of our work is to study the contribution of the echocardiographic Doppler in the diagnosis of the CCP. The authors report six cases of CCP proven after surgery. Study by ultrasound Doppler of intracardiac blood flow and their respiratory variations showed the existence of abnormalities. The decrease of 25% of the mitral E wave in inspiration compared to the value observed in expiration, the increase of 100% of the ebb in sus hépatic vein in expiration and the modifications of the flux in pulmonary insufficiency are the most reliable signs for the diagnosis of the CCP. This method seems so interesting for the diagnosis and to estimate the degree of constriction of the CCP.
  La Tunisie médicale 12/2001; 79(11):638-41.
• Article: [Epidemiology of diabetes in a school children population in Tunisia].

  H Ghannem, I Harrabi, R Gaha, L Trabelsi, I Chouchene, A S Essoussi, H Ammar
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  ABSTRACT: Study the diabetes prevalence on children because, in Tunisia there are not any available data concerning the epidemiological profile of diabetes in the population aged less than 19 years. We undertook an epidemiological survey on a representative sample of 1,569 pupils from Sousse in Tunisia aged between 13 and 19 years with a global answer rate of 95.4%. Fasting blood glucose was measured by the glucose oxidase method. The main results showed that prevalences of the moderate hyperglycaemia on an empty stomach (2%) and of the mellitus diabetes (0.4%) did not reveal any significant statistical difference between girls and boys. The moderate hyperglycaemia prevalence varied according to the existence of other cardiovascular risk factors such as hypercholesterolemia (3.3%), arterial hypertension (2.1%) and overweight (3.4%). Our survey has provided a first evaluation related to a population of youngsters on the diabetes prevalence and other cardiovascular risk factors. This would help to sensitise health authorities on the importance of primary prevention and its setting in health clubs at schools.
  Diabetes & Metabolism 12/2001; 27(5 Pt 1):613-7. · 2.41 Impact Factor
• Article: [Effort phlebitis of the upper limb. Report of 5 cases].

  A Mahdhaoui, H Bouraoui, G Jeridi, S Ernez-Hajri, A Ismail, N Jenaieh, F Ben Frej, H Amara, T Mahjoub, E Boughzela, H Ammar
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  ABSTRACT: Deep venous thrombosis (DVT) of upper limbs is extremely rare. DVT related to physical stress is a less known form. The purpose of this study was to outline the clinical pattern and laboratory features as well as the clinical course and outcome of this disease. The authors report 5 documented cases of upper limb DVT related to physical stress: 4 patients were hand workers and 1 was a young athletic man. None of the patients developed pulmonary embolism. Two patients had late sequelae. Treatment is based on prompt and early anticoagulation. Prevention can be achieved by contention, active physiotherapy and professional rehabilitation.
  Journal des Maladies Vasculaires 11/2001; 26(4):248-51. · 0.54 Impact Factor
• Article: [Cardiovascular risk factors among school children in Sousse, Tunisia].

  H Ghannem, K Khlifa, R Gaha, I Harrabi, L Trabelsi, A Haj Fredj, A S Essoussi, H Ammar, M Braham
  Revue d Épidémiologie et de Santé Publique 09/2000; 48(4):409-14. · 0.78 Impact Factor
• Article: [Complicated hydatid cyst of the right atrium simulating myxoma of the tricuspid valve].

  G Jeridi, E Boughzala, S Hajri, A Hediji, H Ammar
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  ABSTRACT: The authors report the case of a 6-year-old girl with multi-organ hydatid disease, revealed by a complication: hydatid cyst of the right atrium. They emphasize the latency and clinical polymorphism of right cardiac sites of hydatid cyst and the severity of its prognosis. The particular site of this right atrial tumour and its relations with the septal leaflet of the tricuspid valve could be confused, on echocardiography, with myxoma of the tricuspid valve. The aetiology in this case was confirmed at surgery.
  Annales de Cardiologie et d Angéiologie 04/1997; 46(3):159-62. · 0.28 Impact Factor
• Article: Unusual presentation of gastric dilatation. Dramatic complete atrioventricular block.

  H Hmouda, L Jemni, G Jeridi, S Ernez-Hajri, H Ammar
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  ABSTRACT: We report a case of gastric dilatation in a ventilated 18-year-old woman, which was revealed by the acute onset of hypotension, sinus bradycardia, and complete atrioventricular block. Hypotension and cardiac rhythm disturbances resolved with intravenous injection of atropine, but recurred a few minutes later and required a second bolus of atropine, which had a transient beneficial effect. Only gastric decompression, as soon as gastric distention was recognized, was able to restore normal cardiac rhythm and adequate blood pressure. This case highlights the seriousness of gastric dilatation and argues for the vagal mechanism of cardiac rhythm and conduction troubles complicating gastric dilatation.
  Chest 09/1994; 106(2):634-6. · 5.25 Impact Factor
• Article: [Familial hypertrophic cardiomyopathy associated with Wolff-Parkinson-White syndrome].

  A Mahdhaoui, H Bouraoui, B Tabarki, M Majdoub, B Trimeche, N Mahdhaoui, S Chabrak, S Ernez-Hajri, G Jeridi, H Ammar
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  ABSTRACT: Familial hypertrophic cardiomyopathy (HCM) with Wolff-Parkinson-White (WPW) syndrome is extremely rare and associated with a high risk of ventricular tachyarrhythmia and sudden death. We report a familial form of hypertrophic cardiomyopathy associated with Wolff-Parkinson-White syndrome in two siblings 7 and 12-year-old. These patients showed progression to left ventricular dilatation. Early recognition and treatment of such forms can improve such evolution and the risk of sudden death.
  Acta clinica Belgica 58(1):54-7. · 0.59 Impact Factor
• Article: [Distribution of cardiovascular risk factors in coronary patients in Sahel, Tunisia].

  M Lihioui, E Boughzala, M Ben Farhat, H Ammar, A Chaouech, R Jemaa, N Kaabachi
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  ABSTRACT: We evaluated cardiovascular risk factors and their association in patients in Sahel, hospitalized for coronary disease over the period 1994-1998. The clinical features of 3455 patients (72.4% men, 1741 with myocardial infarction, 1714 with unstable angina) were analysed on hospital admission. The prevalence of smoking, dyslipidaemia, hypertension, diabetes and obesity was 77.4%, 39.4%, 28.5%, 42.5% and 25.1% respectively in men and 2.9%, 43.7%, 59.2%, 56.6% and 31.9% respectively in women. With this risk factor profile a national strategy of primary prevention and heart health promotion is needed in Tunisia.
  Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-ṣiḥḥīyah li-sharq al-mutawassiṭ 13(3):536-43.