Cardiovocal Syndrome Associated With Idiopathic Pulmonary Arterial Hypertension: A Case Report and Literature Review

Abstract

Cardiovocal syndrome is left recurrent laryngeal nerve palsy associated with cardiovascular disease. Herein, we report a rare case of left recurrent laryngeal nerve palsy caused by idiopathic pulmonary arterial hypertension. A 40-year-old woman diagnosed with idiopathic pulmonary arterial hypertension was referred to our department for occult infection foci in the ear, nose, and throat (ENT). She had no apparent subjective symptoms in the ENT area, including hoarseness. Flexible laryngoscopy revealed left vocal cord paralysis, and contrast-enhanced computed tomography revealed dilatation of the pulmonary trunk, bilateral pulmonary arteries, and right ventricle, suggesting compression of the left recurrent laryngeal nerve. In our daily practice, when we encounter a left recurrent laryngeal nerve palsy that seems to be endogenous, cardiovascular lesions should be ruled out.

Giving Voice to Cardiovocal Syndrome: A 26-Year-Old Woman With Hypophonia and Dysphagia

“…Recently, enlargement of the pulmonary arterial trunk or its left branch due to all the etiologies of pulmonary hypertension has received more attention. These include primary pulmonary hypertension [12], pulmonary hypertension secondary to chronic obstructive pulmonary disease (COPD) [13], recurrent pulmonary emboli [14], and congenital anomaly of the pulmonary vasculature and lung development [15]. To my knowledge, this is the first case of cardiovocal syndrome attributable to downstream effects of obstructive sleep apnea.…”

MicroRNA and lncRNA as the Future of Pulmonary Arterial Hypertension Treatment

“…Symptoms of PH include exerciseinduced shortness of breath, excessive tiredness, shortness of breath when bending forward (bendopnea), palpitations, exercise-induced abdominal bloating and nausea, weight gain 2 of 15 due to fluid retention, and fainting (during or shortly after exercise). Rare symptoms caused by pulmonary artery dilatation include exertional chest pain (associated with dynamic compression of the left main coronary artery) and hoarseness (caused by compression of the left recurrent laryngeal nerve-i.e., cardiovocal syndrome or Ortner's syndrome) [1,9,10].…”