Ortner's syndrome: Hoarseness of voice revealing severe secondary pulmonary hypertension.

Ortner's syndrome or cardiovocal syndrome is a rare condition referring to laryngeal recurrent nerve paralysis due to cardiovascular conditions. We report the case of a 66-year-old man, with a medical history of active smoking, who complained of hoarseness of voice secondary to vocal cord palsy. A neck and thoracic CT scan revealed severe enlargement of pulmonary main artery, which caused compression of the left recurrent laryngeal nerve in the aortopulmonary window. The prolonged course of the left laryngeal nerve makes it susceptible to injury from cardiovascular structures in the mediastinum. Consequently, cardiovascular conditions such as dilated pulmonary artery or an aneurysm of the aortic arch can compress the nerve, resulting in Ortner's syndrome.