Hoarseness as a Presenting Symptom of Ortner's Syndrome: Two Rare Cardiovascular Cases With an Otolaryngology - First Presentation and Literature Review.

Ortner's syndrome (cardiac-vocal cord syndrome) is characterized by vocal cord paralysis resulting from underlying cardiovascular conditions. It is typically caused by compression of the left recurrent laryngeal nerve by the pulmonary artery or left atrium, as it passes between the pulmonary artery and aortic arch, leading to left vocal cord paralysis and hoarseness. We report 2 rare cases of hoarseness ultimately diagnosed as Ortner's syndrome (ages 54 and 71). The first case involved a bicuspid aortic valve with an ascending aortic aneurysm, with a clinical course lasting over 10 years due to the rarity of the condition. The second case involved an aortic pseudoaneurysm. Both patients had resolution of hoarseness and coughing postoperatively. These cases emphasize the importance of considering rare, life-threatening cardiovascular causes in the differential diagnosis of hoarseness, highlighting the need for early diagnosis and intervention.