Ortner Syndrome due to Concomitant Mitral Stenosis and Bronchiectasis

Abstract

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.

Ortner’s Syndrome in the Modern Era: A Series of 7 Cases

“…However, because of rarity and lack of proper attention to changes in voice in a patient with cardiovascular or other pathology, this is likely that some cases might be missed. OS was fi rst described by Nobert Ortner, a Viennese physician in 1897 [1], and subsequently, by others, in cases of mitral stenosis [5][6][7] In our series, mitral stenosis was the underlying cause in 3 out of 7 cases, however, in 1 case [3] mitral stenosis was complicated by bronchiectasis causing pulmonary hypertension. Another case of OS was due to mitral valve prolapse accompanied by severe mitral regurgitation and hugely dilated left atrium.…”

“…A 35-year-old lady [3], presented with progressive breathlessness, recurrent episodes of productive cough and occasional haemoptysis for 6 months, and hoarseness of voice…”

Ortner\'s Syndrome: Unusual Entity of Pulmonary Hypertension in Pulmonary Tuberculosis

“…9 A case of Ortner 's syndrome due to pulmonary hypertension secondary to concomitant mitral stenosis and bronchiectasis has been reported. 10 Bilateral bronchiectasis probably contributed to the major share of the severity of pulmonary hypertension, which ultimately caused dilatation of the pulmonary arteries. 10 In our case, bilateral upper zone pleuroparenchymal fibrosis along with distortion of bronchovascular structures occurred with time as sequelae of pulmonary TB.…”

“…10 Bilateral bronchiectasis probably contributed to the major share of the severity of pulmonary hypertension, which ultimately caused dilatation of the pulmonary arteries. 10 In our case, bilateral upper zone pleuroparenchymal fibrosis along with distortion of bronchovascular structures occurred with time as sequelae of pulmonary TB. Pulmonary structural damage and pulmonary function abnormalities (severe obstruction) leading to gas exchange abnormalities and chronic hypoxia which have been shown to be a risk factor for pulmonary hypertention.…”

Cardiovocal Syndrome Secondary to an Aortic Aneurysm

“…Nobert Ortner first described hoarseness, which resulted from left recurrent laryngeal nerve palsy, in three patients with severe mitral stenosis in 1897 [ 1 ]. Later in 1958, Stocker and Enterline further identified hoarseness attributable to recurrent laryngeal nerve paralysis caused by cardiovascular disease as cardiovocal syndrome [ 2 , 3 ].…”