Reversal of hoarseness with recognition of Ortner syndrome in a patient with severe mitral regurgitation

Victor Chien Chia Wu*, Chun Chi Chen, Kuo Chun Hung, Ming Shyan Chern, Yung Liang Wan, Feng Chun Tsai, Fen Chiung Lin

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

5 Scopus citations


Loss of voice due to vocal cord paralysis, as in Ortner syndrome, is secondary to left recurrent laryngeal nerve palsy. Cardiovascular cause should be listed as a differential diagnosis of hoarseness and is incumbent upon the diagnostic physician to be familiar with the condition. A 56-year-old male presented to our emergency department with shortness of breath due to severe mitral regurgitation. Incidental finding of aggravating hoarseness during the past six months was suspected to be related to his cardiac condition with hugely dilated left atrium. After an ear nose and throat specialist confirmed left vocal cord paralysis, a cardiac surgeon was consulted for surgical management. The operation consisted of mitral valve repair, tricuspid valve repair, left atrial reduction, and Cox maze procedure. Three days after surgery the patient had noticeable improvement in his voice, and 3 months later he had complete resolution of the hoarseness. Awareness of Ortner syndrome and a search for treatable cause of vocal cord palsy therefore is imperative before the nerve injury becomes irreversible<. Learning objective: Hoarseness in unusual clinical setting (i.e. other than in common cold), should raise suspicion and alert physician to search for primary cause of the symptoms. Ortner syndrome, due to left recurrent laryngeal nerve palsy secondary to cardiovascular disease, is an important differential diagnosis of loss of voice. Comprehensive evaluation and timely intervention allow reversal of the damage to left recurrent laryngeal nerve, whereas delay in diagnosis may lead to permanent nerve injury>.

Original languageEnglish
Pages (from-to)e48-e50
JournalJournal of Cardiology Cases
Issue number2
StatePublished - 02 2013


  • Cardiovocal syndrome
  • Giant left atrium
  • Left recurrent laryngeal nerve palsy
  • Ortner syndrome
  • Severe mitral regurgitation


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