Introduction: Ortner's syndrome is a rare condition, known as cardiovocal condition as patients present with hoarseness of voice due to cardiovascular causes. Case presentation: We present a case of Ortner's syndrome secondary to leaking thoracic aortic aneurysm in a patient who came to emergency department with hypotension and hoarseness of voice for 3 months. Focused cardiac ultrasound (FOCUS) and rapid ultrasound in shock (RUSH) were performed which revealed a thoracic aortic arch aneurysm. Discussion: Focused cardiac ultrasound and rapid ultrasound in shock examination in the emergency department had expedited the diagnosis of this rare condition, hence the subsequent definitive investigation and management. Conclusion: This case highlights the need for high index of suspicion for thoracic aneurysm in patients with unexplained cardiovocal symptoms. It also highlights the importance of point-of-care ultrasound in the emergency department and the significance of utilizing the suprasternal view to look for pathology at the arch of aorta.