Mohamed Abdul Latiff, Zain Mollyza Mohd
Department of Medicine, Hospital Universiti Kebangsaan Malaysia, Jalan Tenteram, Bandar Tun Razak, 56000 Cheras, Malaysia.
Malays J Med Sci. 2004 Jul;11(2):65-8.
Rheumatic mitral stenosis is prevalent in this part of the world and it gives rise to wide array of manifestations. However, hoarseness of voice secondary to recurrent laryngeal nerve paralysis (Ortner's syndrome) is an uncommon manifestation. This case illustrates an uncommon presentation in a common disease. A 29-year-old lady presented with a 2-year history of hoarseness of voice. Physical examination revealed a mid-diastolic murmur and left vocal cord paralysis. Echocardiography confirmed mitral stenosis with pulmonary hypertension. She underwent percutaneous mitral balloon valvotomy in 1991 with return of normal speech after a few months. The recurrent laryngeal nerve paralysis is mainly due to the compression by an enlarged pulmonary artery as initially thought. This complication is rarely seen nowadays due to greater awareness of the disease and earlier intervention. With the advent of percutaneous transvenous mitral valvotomy in the nineties, effective non-surgical intervention is plausible.
风湿性二尖瓣狭窄在世界的这一地区很普遍，它会引发一系列广泛的表现。然而，继发于喉返神经麻痹（奥尔特纳综合征）的声音嘶哑是一种不常见的表现。本病例说明了一种常见疾病中的不寻常表现。一名29岁女性因声音嘶哑2年前来就诊。体格检查发现舒张中期杂音和左侧声带麻痹。超声心动图证实二尖瓣狭窄伴肺动脉高压。她于1991年接受了经皮二尖瓣球囊瓣膜成形术，几个月后声音恢复正常。起初认为喉返神经麻痹主要是由于肺动脉扩大压迫所致。由于对该疾病的认识提高和早期干预，如今这种并发症很少见。随着九十年代经皮经静脉二尖瓣瓣膜成形术的出现，有效的非手术干预成为可能。
