Left vocal cord paralysis secondary to pseudocoarctation of the aorta

Case contributed by Dr Vincent Tatco

Presentation

Presented with hoarseness. Left vocal cord paralysis was considered.

Patient Data

Age: 45 years old
Gender: Male

The upper mediastinum is widened. The aorta is tortuous. 

There is dilatation of the left laryngeal ventricle with medialization of the posterior aspect of the left vocal cord consistent with left vocal cord paralysis.

The aorta distal to the origin of the left subclavian artery is elongated and redundant with buckling and apparent luminal narrowing at the left of the ligamentum arteriosum. The descending segment of the aorta distal to the buckled segment is dilated. The descending aorta measures 3.7 cm in maximum diameter. There is no dissection, collateral circulation, or contrast extravasation. The dilated descending segment of the aorta indents the left pulmonary artery and obliterates the aortopulmonary window posterior to the ligamentum arteriosum.

Case Discussion

This is a case of pseudocoarctation of the aorta with secondary left vocal cord paralysis. The dilated descending segment of the aorta obliterates the aortopulmonary window posterior to the ligamentum arteriosum. The left vocal paralysis may arise from compression of the left recurrent laryngeal nerve as it passes within obliterated aortopulmonary window posterior to the ligamentum arteriosum (Ortner's syndrome or cardiovocal syndrome).

 

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Case information

rID: 46542
Case created: 7th Jul 2016
Last edited: 8th Jul 2016
Inclusion in quiz mode: Included

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