Ortner's syndrome due to aneurysmal dilatation of the left pulmonary artery secondary to mixed pulmonary valve disease.

A young female patient was referred by her general practitioner to the ear, nose and throat outpatient clinic with a 5-year history of progressive hoarseness and loss of voice. A chest radiograph was reported as showing marked dilatation of the left pulmonary artery without any other features to suggest underlying pulmonary arterial hypertension. A provisional diagnosis of left recurrent laryngeal nerve palsy secondary to its compression between the left pulmonary artery and the undersurface of the aortic arch-Ortner's or cardiovocal syndrome-was suggested and confirmed on further investigation including CT, microlaryngoscopy and echocardiography.