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Dysphagia and Hoarseness Associated with Painless Aortic Dissection: A Rare Case of Cardiovocal Syndrome

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Abstract

Cardiovocal syndrome (Ortner’s syndrome) is characterized by left recurrent laryngeal nerve palsy due to cardiovascular disease, but in rare cases it can also be caused by aortic dissection. An 81-year-old man with hypertension was admitted to the hospital with aspiration pneumonia. He had been developing progressive dysphagia and hoarseness for several months before admission. A videofluoroscopic swallowing study showed supraglottic penetration with barium paste and liquid. Laryngoscopy and electromyography revealed left vocal cord palsy caused by left recurrent laryngeal neuropathy, and a contrast-enhanced chest CT revealed dissection of the aortic arch.

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References

  1. Ortner N: Recurrenslähmung bei Mitralstenose. Wien Klin Wochenschr 10:753–755, 1897

    Google Scholar 

  2. Yumoto E, Minoda R, Hyodo M, Yamagata T: Causes of recurrent laryngeal nerve paralysis. Auris Nasus Larynx 29:41–45, 2002

    Article  PubMed  Google Scholar 

  3. King FH, Hitzig WM, Fishberg AM: Recurrent laryngeal nerve paralysis in left ventricular failure. Am J Med Sci 188:691–697, 1934

    Google Scholar 

  4. Dolowitz DA, Lewis CS: Left vocal cord paralysis associated with cardiac disease. Am J Med 4:856–861, 1948

    Article  PubMed  CAS  Google Scholar 

  5. Talley JD, Fowler K: Tetralogy of Fallot (Eisenmenger type) with hypoplasia of dextroposed aorta. Am J Med Sci 191:618–626, 1936

    Google Scholar 

  6. Kishan CV, Wongpraparut N, Adeleke K, Frechie P, Kotler MN: Ortner’s syndrome in association with mitral valve prolapse. Clin Cardiol 23:295–297, 2000

    Article  PubMed  CAS  Google Scholar 

  7. Masatoshi N, Sawayama T, Smukawa M, Mitake H, Nezuo S, Fuseno H, Hasegawa K: Left recurrent laryngeal nerve palsy associated with primary pulmonary hypertension and patent ductus arteriosus. J Am Coll Cardiol 5:788–792, 1985

    Article  Google Scholar 

  8. Thirlwall AS: Ortner’s syndrome: a centenary review of unilateral recurrent laryngeal nerve palsy secondary to cardiothoracic disease. J Laryngol Otol 111:869–871, 1997

    Article  PubMed  CAS  Google Scholar 

  9. Khan IA, Wattanasauwan N, Ansari AW: Painless aortic dissection presenting as hoarseness of voice: cardiovocal syndrome: Ortner’s syndrome. Am J Emerg Med 17:361–363, 1999

    Article  PubMed  CAS  Google Scholar 

  10. Charbel S, Sargi Z, Rassi B: Cardiovocal syndrome: A rare case of painless aortic dissection presenting as isolated dysphonia. Otolaryngol Head Neck Surg 131:332–333, 2004

    Article  PubMed  Google Scholar 

  11. Perie S, Laccourreye O, Bou-Malhab F, Brasnu D: Aspiration in unilateral recurrent laryngeal nerve paralysis after surgery. Am J Otolaryngol 19:18–23, 1998

    Article  PubMed  CAS  Google Scholar 

  12. Heitmiller RF, Tseng E, Jones B: Prevalence of aspiration and laryngeal penetration in patients with unilateral vocal fold motion impairment. Dysphagia 15:184–187, 2000

    Article  PubMed  CAS  Google Scholar 

  13. Sakiyalak P, Bellon EM, David P, Ankeny JL: Esophageal obstruction due to saccular aneurysm of the distal thoracic aorta. J Thorac Cardiovasc Surg 64:959–962, 1972

    PubMed  CAS  Google Scholar 

  14. Gerber O, Heyer EJ, Vieux U: Painless dissecting of the aorta presenting as acute neurologic syndrome. Stroke 17:644–647, 1986

    PubMed  CAS  Google Scholar 

  15. Kuhlmann TP, Powers RP: Painless aortic dissection: an unusual cause of syncope. Ann Emerg Med 13:549–551, 1984

    Article  PubMed  CAS  Google Scholar 

  16. Holloway SF, Fayad PB, Kalb RG, Guarnaccia JB, Waxman SG: Painless aortic dissection presenting as a myelopathy. J Neurol Sci 120:141–144, 1993

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Sang-Il Lee MD, Sung-Bom Pyun MD, PhD & Dae-Hyun Jang MD

  2. Department of Physical Medicine and Rehabilitation, Asan Medical Center, 388-1, Pungnap-2-dong, Song-Pa Gu, Seoul, 138-736, South Korea

    Sung-Bom Pyun MD, PhD

Authors
  1. Sang-Il Lee MD
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  2. Sung-Bom Pyun MD, PhD
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  3. Dae-Hyun Jang MD
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Corresponding author

Correspondence to Sung-Bom Pyun MD, PhD.

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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

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Lee, SI., Pyun, SB. & Jang, DH. Dysphagia and Hoarseness Associated with Painless Aortic Dissection: A Rare Case of Cardiovocal Syndrome. Dysphagia 21, 129–132 (2006). https://doi.org/10.1007/s00455-006-9015-x

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  • DOI: https://doi.org/10.1007/s00455-006-9015-x

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