Severe mitral regurgitation causing Ortner’s syndrome

Hannah Kempton, Lucy McGrath-Cadell, James Nadel, Justin Phan, Ning Song, Kate Kearney, Nicole Bart, Paul Jansz

Clinical Case

A 72-year-old man presented with sudden onset of hoarse voice. Laryngeal endoscopy revealed an immobile left vocal cord during phonation. His relevant cardiac background included non-ischaemic dilated cardiomyopathy. Transthoracic echocardiography revealed severe mitral regurgitation into a massive left atrium. The severe left atrial dilatation was found to be compressing the recurrent laryngeal nerve, causing vocal cord paralysis, or Ortner’s Syndrome. He underwent open mitral and aortic valve replacement, and tricuspid

valvuloplasty. Post-operative echocardiogram demonstrated well functioning valve prostheses, though atrial dilatation persisted. Clinically, the patient’s hoarse voice persisted. He was referred for consideration for surgical correction of the vocal cord paralysis.