Hoarseness Secondary to Left Atrial Myxoma

Rubens, Fraser D.; Goldstein, William; Hickey, N; Dennie, Carole; Keon, Wilbert J.

doi:10.1378/chest.95.5.1139

Cited by 17 publications

(9 citation statements)

References 5 publications

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“…atrial septal defect [7] . patent ductus arteriosus [8,9] , primary pulmonary hypertension [10,11,12] , recurrent pulmonary artery embolism [13] , mitral regurgitation [14] , atrial myxoma [15] , left ventricular aneurysm [16] , corpulmonale [17] and various types of aortic aneurysms [18,9,21] . The type of aortic aneurisms that are associated with Left recurrent laryngeal nerve palsy includes Saccular, Atherosclerotic, Pseudo aneurisms, Dissections, Traumatic and Mycotic aneurisms.…”

Section: Discussionmentioning

confidence: 99%

Cardiovocal syndrom arare case of hoarseness of voice

Ekanayake

Dayaratne²

2020

Ceylon J Otolaryngology

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IntroductionHoarseness of voice is a common clinical presentation in ENT practice, which may have different etiological causes. The causes may vary from local pathology of larynx to a neurogenic reason of central nervous system or recurrent laryngeal nerve pathology. Cardiovocal syndrome may cause hoarseness secondary to left recurrent laryngeal nerve palsy when left recurrent laryngeal nerve is mechanically affected due to enlarged cardiovascular structure. In this article we present a case of left recurrent laryngeal nerve palsy due to Cardiovocal syndrome or Ortner’s syndrome in a 75-year-old female. ConclusionsOrtner's syndrome may be overlooked and unless specifically looked for may be regarded as an idiopathic cause. The diagnostic methods currently used for investigation of recurrent laryngeal nerve palsy specially the CT scan of carina to skull base may have these inherited disadvantages. As the lowest plane of the scan is so proximal to inferior region of the aorto pulmonary window an interpreter may easily miss the aneurism unless specifically looked for. One effect of this would be under diagnosis and when spotted it would be highly inadequate to assess the heart and rest of the thoracic aorta as clearly demonstrated in our patient which needed further studies. It would be a more efficient to include the heart in the CT scans in patients with extra laryngeal causes of left recurrent laryngeal nerve palsy at least among cardiovascular risk factors.

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Section: Discussionmentioning

confidence: 99%

Cardiovocal syndrom arare case of hoarseness of voice

Ekanayake

Dayaratne²

2020

Ceylon J Otolaryngology

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“…Subsequently, it was reported with mitral stenosis,2)3) mitral regurgitation,4) atrial myxoma,5) primary pulmonary hypertension,6)7) thoracic aortic aneurysm,8)9) aortic dissection,10) pulmonary embolism,11) defibrillation,12) transcatheter ablation of atrial fibrillation,13) cardiothoracic surgery14) and heart-lung transplantation 15). The basic abnormality is paralysis of the left recurrent laryngeal nerve.…”

Section: Discussionmentioning

confidence: 99%

Ortner Syndrome due to Concomitant Mitral Stenosis and Bronchiectasis

2012

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Ortner syndrome or cardiovocal syndrome is a rare condition characterized by hoarseness of voice associated with cardiovascular pathology. Compression of the left recurrent laryngeal nerve by the pulmonary artery or left atrium is usually responsible. Recurrent aspiration pneumonia may cause significant morbidity and mortality. Early recognition and treatment along with removal of the underlying cause, if possible, may change an otherwise poor prognosis of the condition. The case presented here describes a 35-year old female with hoarseness of voice in association with mitral stenosis and bronchiectasis. Presence of dual pathology contributed to the overall pathophysiology of the disease, and made its management difficult.

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“…Although it was initially associated with mitral stenosis, several other case reports suggested that hoarseness can be caused and associated by numerous cardiovascular pathologies [ 5 , 6 ]. In particular, these can be congenital conditions (atrial and ventricular septal defect, aortopulmonary window, double outlet right ventricle) [ 7 - 9 ], adult disorders (left atrial enlargement, left ventricular aneurysm, thrombosed giant left atrium [ 10 ], atrial myxoma [ 11 ], aortic aneu-rysms [ 12 - 14 ] or pseudoaneurysms [ 15 ]), iatrogenic lesions (cardiac surgery [ 16 , 17 ], thoracic surgery [ 18 ], atrial fibrillation ablation procedure [ 19 ]). The termed “cardiovocal syndrome” was used in this cases [ 6 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Delayed recurrent nerve paralysis following post-traumatic aortic pseudoaneurysm

et al. 2016

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AbstractBlunt trauma to the neck or to the chest are increasingly observed in the emergency clinical practice. They usually follow motor vehicle accidents or may be work or sports related. A wide pattern of clinical presentation can be potentially encountered. We report the uncommon case of a patient who was referred to our observation presenting with hoarseness and disphagia. Twenty days before he had sustained a car accident with trauma to the chest, neck and the mandible. Laryngoscopy showed a left recurrent laryngeal nerve palsy. Further otolaryngo-logical examination showed no other abnormality. At CT and MR imaging a post-traumatic aortic pseudoaneurysm was revealed. The aortic pseudoaneurysm was consequently repaired by implantation of an endovascular stent graft under local anesthesia. The patient was discharged 10 days later. At 30-days follow-up laryngoscopy the left vocal cord palsy was completely resolved.Hoarseness associated with a dilated left atrium in a patient with mitral valve stenosis was initially described by Ortner more than a century ago. Since then several non malignant, cardiovascular, intrathoracic disease that results in embarrassment from recurrent laryngeal nerve palsy usually by stretching, pulling or compression; thus, the correlations of these pathologies was termed as cardiovocal syndrome or Ortner’s syndrome. The reported case illustrates that life-threatening cardiovascular comorbidities can cause hoarseness and that an impaired recurrent laryngeal nerve might be correctable.

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Hoarseness Secondary to Left Atrial Myxoma

Cited by 17 publications

References 5 publications

Cardiovocal syndrom arare case of hoarseness of voice

Cardiovocal syndrom arare case of hoarseness of voice

Ortner Syndrome due to Concomitant Mitral Stenosis and Bronchiectasis

Delayed recurrent nerve paralysis following post-traumatic aortic pseudoaneurysm

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