Ortner's syndrome associated with hypertensive cardiac disease.

We report an 83-year-old man complaining of hoarseness and dyspnea on exertion for two days. He had stopped taking an antihypertensive drug for three months. Physical examinations on admission revealed the left vocal cord fixed in the paramedian position. Radiological examinations showed severe pulmonary congestion, cardiomegaly, pleural effusion, and swelling of the mediastinal lymph nodes. Plasma level of BNP was elevated. These findings indicated pulmonary congestion due to left heart failure. Treatment with diuretic was started from the date of admission. Along with relief of symptoms from heart failure, his hoarseness improved and almost disappeared three weeks after the beginning of treatment. Laryngoscope demonstrated improvement in the left recurrent nerve paralysis on the 28th day after the beginning of treatment.