Elizondo-Azuela R, Vizcaíno-Alarcón A

Language: Spanish
References: 13
Page: 200-206
PDF size: 407.80 Kb.

ABSTRACT

Ortner’s syndrome or cardiovocal (CVS) is characterized by the paralysis of the left vocal cord, caused by a cardiovascular disease. The patent ductus arteriosus (PDA) is caused by the persistence of a blood vessel that in the fetal stage connects two major arteries, the aorta with the pulmonary artery; this should close during the first week of life. The case of a 16-month infant, with a large PDA and medical treatment since four months of age, with digoxin, furosemide and espironolactone, controlled with biplane ECHO doppler, while definite treatment was considered PDA occlusion by catheterization or thoracotomy is presented. While an improvement occurred haemodynamicly, diuretics were decreased, in three weeks’ time the patient developed progressive dysphonia. In five weeks’ time, a direct laryngoscopy was performed, showing left vocal cord paresi. Doppler’s ECHO indicated an increase in flow and widening of the PDA, diuretic treatment was restarted and dysphonia disappeared in 15 days. At thoracotomy closure of the PDA was accomplished without complications. Cardiovocal syndrome has low prevalence in adults with cardiovascular diseases, and is even less frequent in infant population; nonetheless it should be in the patient’s differential diagnosis of left laryngeal recurrent nerve paralysis (LLRNP). Hence the specialist should perform an integral patient’s evaluation.

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