A Case of Hoarseness with Acute Back Pain - Cardiovocal Syndrome Revisited

Authors

  • Timothy Xin Zhong Tan
  • Tharmmambal Balakrishnan
  • Moses Ho Hon Lam
  • Yan Yee Chui
  • Lionel Tim-Ee Cheng

DOI:

https://doi.org/10.3941/jrcr.v13i7.3580

Keywords:

Cardiovocal syndrome, Ortner syndrome, Aortic dissection, Hoarseness, CT Aortogram

Abstract

A previously well 81-year-old Chinese male presented with hoarseness and low back pain for one month. Chest radiography at presentation revealed widening of the mediastinal silhouette. Nasopharyngoscopy detected left vocal cord paralysis. CT aortogram revealed a large saccular aortic arch aneurysm with a dissection flap extending distally down to the aortic bifurcation. The combination of clinical and imaging findings was consistent with cardiovocal syndrome. In view of good premorbid function, surgical repair was offered, and the patient underwent surgical repair and recovered well with no further back pain. A review of cases of cardiovocal syndrome suggest that prognosis of recurrent laryngeal nerve paralysis is dependent on the degree and duration of compression, and usually persists despite treatment of the underlying aneurysm.

Author Biographies

Timothy Xin Zhong Tan

Department of Emergency Medicine, Singapore General Hospital, Singapore

Tharmmambal Balakrishnan

Department of Internal Medicine, Singapore General Hospital, Singapore

Moses Ho Hon Lam

Department of Internal Medicine, Singapore General Hospital, Singapore

Yan Yee Chui

Department of Internal Medicine, Princess Margaret Hospital, Hong Kong

Lionel Tim-Ee Cheng

Department of Diagnostic Radiology, Singapore General Hospital, Singapore

Published

2019-07-26

Issue

Section

Thoracic Radiology