An 11-year-old male, who complained of hoarseness and fatigue on effortpresented to our institution for evaluation. Left vocal cord paralysis andsevere pulmonary hypertension was diagnosed. The patient had an enlargedpulmonary artery due to pulmonary hypertension which was responsiblefor compression to left vocal cord paralysis causing hoarseness. Ortner’ssyndrome or cardiovocal syndrome is known as hoarseness due to left vocalcord paralysis secondary to cardiac pathologies. Although hoarseness of voiceis frequently encountered in the otorhinolaryngology clinics, pulmonaryhypertension related hoarseness is an unusual presentation in childhood.
___
1. Subramaniam V, Herle A, Mohammed N, Thahir M. Ortner's syndrome: case series and literature review. Braz J Otorhinolaryngol 2011; 77: 559-562.
2. Heikkinen J, Milger K, Alejandre-Lafont E, et al. Cardiovocal syndrome (Ortner's syndrome) associated with chronic thromboembolic pulmonary hypertension and giant pulmonary artery aneurysm: Case report and review of the literature. Case Rep Med 2012; 2012: 230736.
3. Condon LM, Katkov H, Singh A, Helseth HK. Cardiovocal syndrome in infancy. Pediatrics 1985; 76: 22-25.
4. Robida A, Povhe B. Cardiovocal syndrome in an infant with a double outlet of the right ventricle. Eur J Pediatr 1988; 148: 15-16.
5. Zaki SA, Asif S, Shanbag P. Ortner syndrome in infants. Indian Pediatr 2010; 47: 351-353.
6. David JJ, Mohanlal S, Sankhe P, Ghildiyal Y. Unilateral right pulmonary artery agenesis and congenital cystic adenomatoid malformation of the right lung with Ortner's syndrome. Lung India 2016; 33: 553-555.
7. Lammers AE, Adatia I, Del Cerro MJ, et al. Functional classification of pulmonary hypertension in children: report from the PVRI Pediatric Taskforce, Panama 2011. Pulm Circ 2011; 1: 280-285.
8. Ortner N. Recurrenslahmung bei mitral stenose. Wien Klin Wochenschr 1897; 10: 753-755.
9. Fetterolf G, Norris GW. The anatomical explanation of the paralysis of the left recurrent laryngeal nerve found in certain cases of mitral stenosis. Am J Med Sci 1911; 141: 625-638.
10. Plastiras SC, Pamboucas C, Zafiriou T, Lazaris N, Toumanidis S. Ortner’s syndrome: a multifactorial cardiovocal syndrome. Clin Cardiol 2010; 33: E99-E100.
11. Nakao M, Sawayama T, Samukawa M, et al. Left recurrent laryngeal nerve palsy associated with primary pulmonary hypertension and patent ductus arteriosus. J Am Coll Cardiol 1985; 5: 788-792.
12. Mulpuru SK,Vasavada BC, Punukollu GK, Patel AG. Cardiovocal syndrome: a systematic review. Heart Lung Circ 2008; 17: 1-4.
13. Yasui T, Kasamatsu N, Seto T, Shinozuka N, Nakamura A, Hashizume I. A case of Ortner syndrome caused by primary pulmonary hypertension. Nihon Kokyuki Gakkai Zasshi 2006; 44: 823-827.
14. Nakahira M, Nakatani H, Takeda T. Left vocal cord paralysis associated with long-standing patent ductus arteriosus. AJNR Am J Neuroradiol 2001; 22: 759- 761.
15. Paquette CM, Manos DC, Psooy BJ. Unilateral vocal cord paralysis: a review of CT findings, mediastinal causes, and the course of the recurrent laryngeal nerves. Radiographics 2012; 32: 721-740.