There could be protean cardiac lesions in Behcet disease with poor prognosis. All the three layers could be involved, including pericarditis, myocarditis and endocarditis. Valvular regurgitation can occur as part of the endocardial involvement. Coronary arteritis with or without myocardial infarction, intracardiac thrombi and even endomyocardial fibrotic lesions have been described in Behcet’s disease. Aneurysms can occur in the coronary arteries and in the aortic sinuses of Valsalva. Oral anticoagulants, immunosuppressants, and colchicine have been used in the treatment of Behcet disease with cardiac involvement [Geri G et al. Spectrum of Cardiac Lesions in Behcet Disease: A Series of 52 Patients and Review of the Literature. Medicine (Baltimore). 2012;91:25-34]. It may be noted that Behcet’s disease is a multi system disease with an autoimmune basis.