Hoarseness attributed to vocal cord palsy is associated with injury to the recurrent laryngeal nerve. Hoarseness resulting from left recurrent laryngeal nerve palsy, cardiovocal syndrome (Ortner's syndrome), has rarely been reported. We present the case of a 79-year-old male suffering from hoarseness in the absence of significant clinical manifestations. A flexible laryngoscope was used to identify a paralyzed left vocal cord, and contrast-enhanced computed tomography showed a large thrombus-filled aneurysmal dilation of the aortic arch. The severity of the vocal cord paralysis was improved by surgical intervention. This case illustrates that life-threatening cardiovascular comorbidities can cause hoarseness and that an impaired recurrent laryngeal nerve might be correctable.

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