Hoarseness of Voice as a Primary Presentation of Pulmonary Hypertension: a Rare case of Ortner’s (Cardio-vocal) Syndrome


  • Kashif Naeem Al Baraha hospital, Deira, Dubai, UAE.
  • Vinod Choondal Al Baraha hospital, Deira, Dubai, UAE.




Ortner’s syndrome, Pulmonary hypertension, Vocal cord palsy.


Ortner’s (cardio-vocal) syndrome is a rare disease entity that involves compression of the left recurrent laryngeal nerve due to enlargement of cardiovascular structures. The syndrome was first described by Norbert Ortner (an Austrian physician) in 1897 and is usually reported to be associated with mitral stenosis. However, we report a rare case when a 20-year-old girl presented with hoarseness of voice and was found to have an enlarged main pulmonary trunk due to pulmonary hypertension that was compressing the left recurrent laryngeal nerve. The case highlights a rare presentation of a relatively common disease and stresses the importance of detailed cardiac workup in a patient with hoarseness of voice. We present the case and review the literature. 


Ramadan HH, Wax MK, Avery S. Outcome and changing cause of unilateral vocal cord paralysis. Otolaryngol Head Neck Surg 1998; 118:199-202.

Ortner N. Recurrent nerve palsy in patient with mitral stenosis (in German). Wien Klin Wochenschr. 1897;10:753-5.

Fetterolf G, Norris G. The anatomical explanation of paralysis of left recurrent laryngeal nerve found in certain case of mitral stenosis. Am J Med Sci. 1911;141:625e638.

Shi-Min Yuan. Ortner (cardio-vocal) syndrome: a collective review. Kuwait Medical Journal 2014; 46(1):3-13.

Panwar CSS, Mehta LCAK, Verma SCRK. High-altitude induced Ortner’s syndrome. Med J Armed Forces India 2004; 60:182-183.

Stoob K, Alkadhi H, Lachat M. Resolution of hoarseness ater endovascular repair of thoracic aortic aneurysm: a case of Ortner’s syndrome. Ann Otol Rhinol Laryngol 2004; 113:43-45.

Shewan LG, Coats AJS, Henein M. Requirements for ethical publishing in biomedical journals. International Cardiovascular Forum Journal 2015;2:2. DOI 10.17987/icfj.v2il.4






Letters to the Editor