Background: Hoarseness caused by Ortner's syndrome is a rare diagnosis, first described in 1897 in a patient with an enlarged left atrium due to mitral valve stenosis. Due to mechanical compression on the left recurrent laryngeal nerve patients present with hoarseness.
Case desciption: A 70 year old male presents with hoarseness and an inability to swallow. Examination reveals a paresis of the left vocal cord. A Computed Tomography scan shows a saccular aneurysm of the proximal descending thoracic aorta, consistent with Ortner's syndrome. Patient was successfully treated with a thoracic endovascular aortic repair procedure.
Conclusion: Hoarseness is rarely caused by cardiovascular conditions, a more common condition is a lung neoplasm. Thoracic aneurysms as a cause of Ortner's syndrome are often described in combination with a dissection of the aneurysm. Diagnostic work-up of persisting hoarseness without laryngeal pathology should include a contrast enhanced computed tomography (CT) scan to rule our life-threatening conditions.