DOI: 10.14260/jemds/2014/3756 CASE REPORT J of Evolution of Med and Dent Sci/ eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 3/ Issue 58/Nov 3, 2014 Page 13199 AORTIC ANEURYSM: A RARE CAUSE OF ORTNER’S SYNDROME Sukanta Kodali 1 , Biswal Pradipta Trilochan 2 , Swetapadma Pradhan 3 , Jyoti Patnaik 4 , Manoranjan Dash 5 HOW TO CITE THIS ARTICLE: Sukanta Kodali, Biswal Pradipta Trilochan, Swetapadma Pradhan, Jyoti Patnaik, Manoranjan Dash. “Aortic Aneurysm: A Rare Cause of Ortner’s Syndrome”. Journal of Evolution of Medical and Dental Sciences 2014; Vol. 3, Issue 58, November 3; Page: 13199-13202, DOI: 10.14260/jemds/2014/3756 ABSTRACT: A 60 year old male patient presented with hoarseness of voice lasting for 2 months. First he was examined by the otorhinolaryngologist of our hospital, who noticed absence of movements of the left vocal cord. Chest X-ray showed a large opacity in the left upper zone and the patient was referred to the pulmonologist. His general physical examination was unremarkable not having any stigmata of Marfan's or Ehler Danlos syndrome. On chest auscultation, a systolic flow murmur was audible and there was decreased breath sound in the left infraclavicular area. Bronchoscopy revealed absence of movement of left vocal cord. His trans-thoracic echocardiography revealed degenerative aortic and mitral valve disease with mild aortic regurgitation and mild mitral regurgitation with dilated aortic aneurysm. A contrast enhanced CT scan of thorax and CT Angio Aortogram revealed fusiform aneurysmal dilatation of the arch of aorta with diameter of 6.2 cm over a length of 12.3 cm showing intraluminal partial thrombus with wall calcification. The patient was advised to undergo surgery. However, after detailed discussion with him and his family, they decided for medical management in view of his advanced age. INTRODUCTION: Ortner’s syndrome is a clinical entity defined as hoarseness caused by impairment of the left recurrent laryngeal nerve because of cardiovascular diseases. It was first described in 1897 by Nobert Ortner in a patient with left atrial enlargement secondary to mitral valve stenosis. Subsequently, the entity has been described in other cardiovascular diseases including mitral valve prolapse, atrial and ventricular septal defect, patent ductus arteriosus, pulmonary hypertension, and thoracic aortic aneurysm. 1,2 This syndrome is also known as cardio-vocal syndrome. 3 Thoracic aortic aneurysm presenting as vocal cord paralysis is a rare occurrence. Five percent of recurrent laryngeal nerve palsy is due to thoracic aortic aneurysm. 4 We present a rare case of cardio-vocal hoarseness or Ortner's syndrome secondary to aortic arch aneurysm. CASE REPORT: A 60 year old male patient presented with hoarseness of voice lasting for 2 months. First he was examined by the otorhinolaryngologist of our hospital, who noticed absence of movements of the left vocal cord. Chest X-ray showed a large opacity in the left upper zone (Image-1) and the patient was referred to the pulmonologist. His general physical examination was unremarkable not having any stigmata of Marfan's or Ehler Danlos syndrome. On chest auscultation, a systolic flow murmur was audible and there was decreased breath sound in the left infraclavicular area. Bronchoscopy revealed absence of movement of the left vocal cord. (Image-2) His trans-thoracic echocardiography revealed degenerative aortic and mitral valve disease with mild aortic regurgitation and mild mitral regurgitation with dilated aortic aneurysm. A contrast enhanced CT scan of thorax and CT Angio Aortogram revealed fusiform aneurysmal dilatation of the arch of aorta with diameter of 6.2 cm over a length of 12.3 cm showing