Ortner syndrome as a presenting symptom of severe chronic mitral regurgitation in heart failure: A case report

Ortner's syndrome or cardiovocal syndrome is a clinical condition associated with hoarseness due to left recurrent laryngeal nerve palsy from compression of surrounding cardiovascular structures. Atrial enlargement, commonly caused by chronic mitral regurgitation (MR) may be a source of compression. We present a case of a 53-year-old man with decompensated heart failure (HF) with a new onset of hoarseness. Chest radiograph showed cardiomegaly with evidence of fluid overload; transthoracic echocardiography showed bi-atrial enlargement secondary to severe chronic mitral regurgitation and moderate pulmonary hypertension. As a result, the diagnosis of Ortner's syndrome was made. For patients with new onset hoarseness with a history of severe cardiovascular disease, Ortner's syndrome should be considered and early initiation of therapy can help reduce the incidence.