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

Tammiraju, I.; Krishna, T. Radha; Prasad, P. V. S.; Babu, KamaniNaresh

doi:10.1016/j.ihjccr.2018.02.006

Cited by 7 publications

(11 citation statements)

References 10 publications

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“…Since the left recurrent laryngeal nerve is longer than the right nerve, left vocal cord paralysis is more commonly encountered. In unilateral vocal cord palsy due to thoracic diseases, leftsided vocal cord paralysis was 1.75 times more frequent than right-sided paralysis (Tammiraju et al, 2018).…”

Section: Discussionmentioning

confidence: 90%

“…Study epidemiology in Scotland found that LRLNP tends to affect men in any age group, ranges from age 23 to 85 years, with an average occurring at the age of 61 years. The most common causes are bronchogenic carcinoma (43%) and mitral valve disease (0.6-5%) (Loughran, Alves, & MacGregor, 2002) (Tammiraju et al, 2018). As we know that the etiology of hoarseness may vary, and we have to make a differential diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Vocal cord paralysis, due to left recurrent laryngeal nerve palsy (LRLNP) caused by cardiovascular disease, is called Cardio-vocal syndrome, formerly known as Ortner syndrome (Stocker & Enterline, 1958) (Mulpuru, Vasavada, Punukollu, & Patel, 2008). The etiology of LRLNP were iatrogenic surgical injury (10.4-75%), neoplasms (6.8-42%), infection and metabolic disease (1.5-11%) and idiopathic etiology including cardiovocal syndrome (2.2-23%) (Tammiraju, Krishna, Prasad, & Babu, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, left atrial lesions due to mitral valve disease, presented in 20 patients (7.81%), and congenital heart defects presented in 14 patients (5.47%) (Yuan, 2014). There are several cardio-vocal syndrome cases is reported, Tammiraju et al and Ramasamy et al reported that hoarseness due to mitral stenosis (Tammiraju et al, 2018) (Ramasamy, Kale, Ramalingam, & Veerappa, 2018), and Chen et al in 2009 reported that hoarseness due to large aortic arch aneurysm (Chen, Lin, & Lu, 2009). There is no study nor literature mention the exact number of the incidence of Cardio-vocal syndrome in Indonesia.…”

Section: Introductionmentioning

confidence: 99%

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Cardio-vocal Syndrome as a Complication Patient with Severe Mitral Regurgitation and Moderate Aortic Regurgitation with Pulmonary Hypertension

Basworo

Subagjo²

2021

Qanun Medika

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Hoarseness due to paralysis of vocal cord, as in Cardio-vocal syndrome, is caused by mechanical affection of left recurrent laryngeal nerve from enlarged cardiovascular structures. Mitral valve prolapse is rarely found to cause this syndrome. Case report presenting a 47 years old male visited the outpatient department with a clinical history of dyspnea and hoarseness since a year ago. Physical examination revealed late systolic murmur in apex and low-grade diastolic murmur in right second intercostal space. Echocardiography confirmed severe mitral regurgitation due to flail anterior mitral valve leaflet with severe left atrium dilatation (9.0 cm) and moderate aortic regurgitation due to mal-coaptation of aortic valves. Laryngoscopy revealed an immobile left vocal cord. He underwent successful double valve replacement after three months follow up the patient showed improvement of hoarseness. The incidence of Cardio-vocal syndrome in mitral valve disease varies from 0.6% to 5%. In cases diagnosed with thoracic disease, paralysis of the left vocal cord was reported 1.75 times more frequent than the right side. The aim of this case report is we have to aware that Cardio-vocal syndrome is a rare cause of vocal cord paralysis and should be considered as a differential diagnosis of hoarseness, particularly if the patient has a cardiac history. Comprehensive evaluation and prompt treatment may allow reversal of the damage to left recurrent laryngeal nerve. Permanent nerve damage can occur due to late diagnosis. Keywords : Cardio-vocal syndrome, Mitral regurgitation, Aortic RegurgitationCorrespondence : adityobasworo@gmail.com

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cardio-vocal Syndrome as a Complication Patient with Severe Mitral Regurgitation and Moderate Aortic Regurgitation with Pulmonary Hypertension

Basworo

Subagjo²

2021

Qanun Medika

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“…It has been reported to be an unusually rare phenomenon. Other reports have shown vocal cord paralysis secondary to PAH [11], left ventricular failure [12] and cardiovocal syndrome [8]. Nakahira and colleagues [7] refuted that if the majority of vocal cord paralysis happened due to dilated pulmonary arteries there would be an increase in the number of people with vocal cord paralysis and that is not the case.…”

Section: Discussionmentioning

confidence: 99%

Voice hoarseness in a patient with underlying Eisenmenger's syndrome: A case report

Suryavanshi

Parameswaran

Sharma

et al. 2019

Journal of Otolaryngology - Head & Neck Surgery

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Background The natural history of patients diagnosed with Eisenmenger’s Syndrome typically revolve around the pediatric population. Medical advances have allowed these patients to live longer and present with a different subset of symptoms as a result of the progression of their disease process. Case presentation In this case report, we discuss a 77-year-old Caucasian female with Eisenmenger’s Syndrome presenting with hoarseness. Clinical and imaging studies reveal a left vocal cord paralysis secondary to a progressively enlarging patent ductus arteriosus (PDA) and dilation of pulmonary arteries causing mass effect on the left recurrent laryngeal nerve. Conclusion From a clinical perspective, this case highlights the need for otolaryngologists to be aware of the pathophysiology of Eisenmenger’s Syndrome as it progresses with age.

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Transient Recurrent Laryngeal Nerve Palsy after Interventional Therapy

Mandilaras

Happel

Funk

et al. 2022

Thorac Cardiovasc Surg

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Background: Hoarseness due to laryngeal nerve injury is a known complication after cardiothoracic surgery involving the aortic arch. However, this complication is only rarely reported after catheter interventions. Results: In this article we present the unusual case of a left sided vocal cord paralysis in four patients after primary stenting of a recoarctation, redilatation of a stented coarctation, a primary stenting of the left pulmonary artery and prestenting for percutaneous pulmonary valve implantation with dilation of the left pulmonary artery (LPA). After implanting bare metal stents, it is common practice, whilst contemplating the diameters of the adjacent structures, to optimize the stent diameter in a two-step procedure and dilate the stent until a maximum diameter is achieved and there is no residual gradient after applying this technique. Four of our patients experienced hoarseness after the intervention and a vocal cord paralysis was diagnosed. Angiography revealed no signs of extravasation or dissection. Clinical symptoms improved over the course of the following 6 months; patients with interventions at the aortic arch showed a complete remission, patients with procedures involving the LPA showed only mild regression of the symptoms. Conclusion: To our knowledge, this complication (Ortner-Syndrome, cardiovocal syndrome) after such interventions has rarely been reported before. Although a rare complication, the recognition of these symptoms may support colleagues in managing affected patients. In addition, awareness for hoarseness after interventional therapies and systematic screening for this complication might help to identify patients at risk in the future.

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

Cited by 7 publications

References 10 publications

Cardio-vocal Syndrome as a Complication Patient with Severe Mitral Regurgitation and Moderate Aortic Regurgitation with Pulmonary Hypertension

Cardio-vocal Syndrome as a Complication Patient with Severe Mitral Regurgitation and Moderate Aortic Regurgitation with Pulmonary Hypertension

Voice hoarseness in a patient with underlying Eisenmenger's syndrome: A case report

Transient Recurrent Laryngeal Nerve Palsy after Interventional Therapy

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