Hurtarte Sandoval A R, Carlos Zamora R, Gómez Carrasco J M, Jurado Ramos A
Department of Nephrology, Reina Sofia Hospital, Córdoba, Spain.
Department of Otolaryngology and Head and Neck Surgery Service, Reina Sofia Hospital, Córdoba, Spain.
BMJ Case Rep. 2014 Jul 17;2014:bcr2013202900. doi: 10.1136/bcr-2013-202900.
We present a case of a 67-year-old man who was an active smoker, with a clinical history of ischaemic cardiopathy, hypertension, who presented to the emergency room with hoarseness of voice of 2 weeks duration. No other neurological or cardiorespiratory symptoms were found. Physical examination revealed an aortic regurgitation murmur with radial pulse difference between the upper limbs and femoral pulse difference on lower limbs. Laryngoscopy examination revealed a left vocal cord paralysis in the paramedian position, without signs of malignancy. Thoracoabdominal CT angiography was performed to rule out an aortic dissection. CT revealed a dissection in the descending thoracic aortic arch and abdominal aorta. Cardiovascular surgery was consulted and decided to place endoprosthesis at the thoracic and abdominal aortic area. Hoarseness eventually resolved during the following weeks. Ortner's syndrome is described as hoarseness of voice caused by compression of the left recurrent laryngeal nerve of cardiovascular origin.
我们报告一例67岁男性病例,该患者有长期吸烟史,有缺血性心脏病、高血压病史,因持续2周的声音嘶哑到急诊室就诊。未发现其他神经或心肺症状。体格检查发现主动脉反流杂音,上肢桡动脉搏动与下肢股动脉搏动存在差异。喉镜检查显示左侧声带处于旁正中位麻痹,无恶性病变迹象。进行了胸腹CT血管造影以排除主动脉夹层。CT显示降主动脉弓和腹主动脉有夹层。咨询了心血管外科,决定在胸主动脉和腹主动脉区域放置内支架。声音嘶哑在接下来的几周内最终消失。奥尔特纳综合征被描述为由心血管源性压迫左喉返神经引起的声音嘶哑。