Left recurrent laryngeal palsy (Ortner's syndrome) in schistosomal pulmonary hypertension

Abstract

Ortner's syndrome or the cardiovocal syndrome is the paralysis of the left vocal cord in cases of mitral stenosis associated with large atrium and pulmonary artery dilation. A 34-year-old man, from a Schistosoma mansoni-endemic area in Minas Gerais, Brazil, developed dyspnoea and intermittent hoarseness of voice that soon became constant two years before admission to hospital. Chest X-ray showed enlargement of the heart and main pulmonary artery, while echocardiography revealed dilated right ventricle and paradoxically moved intraventricular septum. Enhanced computed tomography revealed enlarged pulmonary arteries. Dynamic laryngoscopy documented complete paralysis of the left vocal cord.