Ortners syndrome

Original Editor - Ravi Kumar

Top Contributors - Ravi Kumar and Kim Jackson  

Introduction[edit | edit source]

Ortner's syndrome, also known as cardiovocal syndrome, is a rare condition that causes hoarseness of voice due to compression or traction of the left recurrent laryngeal nerve (RLN) by a cardiovascular disorder.[1] The left recurrent laryngeal nerve is a branch of the vagus nerve that passes under the aortic arch and ascends to the larynx. It can be affected by various congenital or acquired diseases that enlarge or distort the structures near the nerve, such as the left atrium, the pulmonary artery, or the aorta. The most common historical cause of Ortner's syndrome is mitral stenosis, which leads to left atrial enlargement and pulmonary hypertension. However, other causes such as atrial septal defect, patent ductus arteriosus, thoracic aortic aneurysm, aortic dissection, and pulmonary embolism have been reported.

This syndrome was first described in 1897 by an Austrian physician Norbert Ortner in three patients with severe mitral valve stenosis.[2]

Etiology[edit | edit source]

The most common causes of Ortner's syndrome are:

  • Mitral valve stenosis
  • Aortic arch aneurysm
  • Dilated pulmonary artery
  • Left atrial enlargement
  • Congenital heart disease
  • Mediastinal tumors
  • Intramural hematoma of the aortic arch

Less common causes include:

  • Thoracic aortic dissection
  • Aortic regurgitation
  • Ventricular septal defect
  • Pericardial effusion
  • Thyroid tumors
  • Esophageal tumors

Symptoms[edit | edit source]

  • Hoarseness or dysphonia
  • Difficulty swallowing or dysphagia
  • Trouble breathing when speaking
  • Shortness of breath
  • Chest pain
  • Cough
  • Difficulty swallowing
  • Wheezing

Diagnosis[edit | edit source]

Ortner's syndrome can be diagnosed by clinical history, physical examination, laryngoscopy, and imaging studies such as chest X-ray, echocardiography, computed tomography, or magnetic resonance imaging.

Other tests that may be helpful in diagnosing Ortner's syndrome include:

  • Pulmonary function testing
  • Electrocardiogram (EKG)
  • Holter monitor
  • Exercise stress test

References[edit | edit source]

  1. Heikkinen J, Milger K, Alejandre-Lafont E, Woitzik C, Litzlbauer D, Vogt JF, Klußmann JP, Ghofrani A, Krombach GA, Tiede H. Cardiovocal syndrome (Ortner's syndrome) associated with chronic thromboembolic pulmonary hypertension and giant pulmonary artery aneurysm: case report and review of the literature. Case reports in medicine. 2012 Jan 1;2012.
  2. Ortner N. Recurrent laryngeal nerve paralysis due to mitral valve stenosis. Wien Klin Wochenschr. 1897;10:753-5.