Ortner's Syndrome  

Oleh:

Prada-Delgado, Oscar ; Barge-Caballero, Eduardo

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 365 no. 10 (Sep. 2011), page 939.
Topik: Progressive Vocal Hoarseness

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2011.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

A 62-year-old woman presented with a 2-year history of progressive vocal hoarseness. She had undergone mitral-valve replacement for rheumatic mitral stenosis 21 years earlier, but her severe pulmonary hypertension had not resolved, and progressive clinical manifestations of right-sided heart failure, including peripheral edema, ascites, and exertional dyspnea, had developed. Chest radiography revealed cardiomegaly without pulmonary vascular congestion (Panel A, arrows, posteroanterior image; Panel B, lateral image). Elevation of the left mainstem bronchus (Panel A, asterisk) along with the calcified, convex contour of the upper posterior heart (Panel B, arrows) suggested long-standing left atrial enlargement. Contrast-enhanced axial computed tomographic imaging of the chest confirmed that the left atrium was grossly enlarged (Panel C, arrows), with a left atrial maximal diameter of 16.8 cm. Left vocal-cord paresis was observed on laryngoscopy, and Ortner's syndrome was diagnosed. In this condition, hoarseness results when a massively dilated left atrium or left pulmonary artery compresses the left recurrent laryngeal nerve. After consideration of the patient's substantial risk of perioperative morbidity, she was discharged while receiving medical therapy for heart failure, with poor symptomatic response and without improvement in voice quality.

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