Ortner’s syndrome (Cardio Vocal Hoarseness) – A rare entity in modern era. A case report

Abstract

Hoarseness of voice is a very common symptom seen in the ENT outpatient department (OPD) and is very less common in cardiac patients. However, hoarseness of voice secondary to recurrent laryngeal nerve paralysis (Ortner’s syndrome/cardiovocal syndrome) is an uncommon manifestation secondary to mitral stenosis. Rheumatic mitral stenosis is prevalent in the developing world and gives rise to wide array of manifestations. This case illustrates an uncommon presentation in a common disease. A 45-year-old male presented with 6 months history of hoarseness of voice, palpitations, and shortness of breath. Physical examination revealed a long mid-diastolic murmur. Echocardiography confirmed mitral stenosis (non pliable valve) with hugely dilated left atrium (5.8 cm), enlarged pulmonary artery (3.92 cm). Video laryngoscopy showed left vocal cord paralysis. After excluding other causes, hoarseness of voice is attributed to the left recurrent laryngeal palsy secondary to left atrial enlargement. This complication is rarely seen nowadays due to greater awareness of the disease and earlier intervention. Early identification and treatment of the underlying cause improves prognosis of this condition. He underwent successful mitral valve replacement. After 3 months there is partial improvement in hoarseness of voice and the patient is under follow-up.

Keywords

• Mitral stenosis
• Ortner’s syndrome
• Left atrial dilatation
• Hoarseness of voice