OrtnerÃ¢ÂÂs Syndrome as First Clinical Presentation of Severe Pulmonar Arterial HypertensionBolaki M1, Fanaridis M1*, Pediaditis E2, Mitrouska I1 and Georgopoulos D1,2
- *Corresponding Author:
- Michail Fanaridis
Department of Pulmonary Medicine
University Hospital of Heraklion, University of Crete
Medical School, P.O. box 1352
E-mail: [email protected]
Received date: November 30, 2016; Accepted date: January 17, 2016; Published date: January 21, 2016
Citation: Bolaki M, Fanaridis M, Pediaditis E, Mitrouska I, Georgopoulos D (2017) Ortner’s Syndrome as First Clinical Presentation of Severe Pulmonar Arterial Hypertension. J Pulm Respir Med 6: 387. doi: 10.4172/2161-105X.1000387
Copyright: © 2016 Bolaki M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
A 40 year old female, non-smoker with a past medical history of urticaria and allergic rhinitis presented with hoarseness of voice of 3 months duration without any accompanying symptoms or limitation of daily activities. Direct laryngoscopy identified palsy of the left vocal cord. The magnetic resonance imaging of the chest indicated abnormal signal intensity in the left vocal cord. The thoracic computed tomography revealed only an enlargement of the pulmonary artery, while transthoracic echocardiography estimated systolic pulmonary artery pressure of 75 mmHg. Pulmonary function tests were compatible with pulmonary vascular disease and cardiopulmonary exercise test showed exercise limitation of cardiocirculatory origin (maximum O2 consumption 60% of pred.). Catheterization of the right heart showed precapillary pulmonary hypertension (mean pulmonary artery pressure 40 mmHg) with a positive response to vasoreactivity test. A diagnosis of idiopathic pulmonary arterial hypertension (IPAH) was made, with hoarseness of voice as the only manifestation of the disease. The hoarseness of voice is believed to be the result of the compression of the left recurrent laryngeal nerve between aorta and the dilated pulmonary artery. This is an unusual case of cardiovocal syndrome (or Ortner’s syndrome) in a patient with IPH who had no perception of dyspnea or limitation of daily activities.