Hoarseness of Voice in a Patient with Mitral Stenosis and Ortner’s Syndrome
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Hoarseness of Voice in a Patient with Mitral Stenosis and Ortner’s Syndrome
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:
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Abdul Latiff Mohamed, Mollyza Mohd Zain
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Hoarseness of Voice in a Patient with Mitral Stenosis and Ortner’s Syndrome
Year: 2004
Copyright (license): CC BY 4.0
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Summary of article contents:
Introduction
Rheumatic mitral stenosis is a common condition in certain regions and manifests in various ways. One rare manifestation is hoarseness of voice caused by recurrent laryngeal nerve paralysis, known as Ortner's syndrome. This case report discusses a 29-year-old lady who presented with a two-year history of hoarseness and subsequently was diagnosed with mitral stenosis accompanied by pulmonary hypertension. She underwent a percutaneous mitral balloon valvotomy, leading to the resolution of her vocal symptoms, illustrating an unusual presentation of a prevalent disease.
The Significance of Ortner’s Syndrome
Ortner's syndrome is characterized by the compression of the left recurrent laryngeal nerve due to anatomical changes associated with mitral stenosis, particularly an enlarged pulmonary artery. Historically, the incidence of this syndrome in patients with mitral valve disease has been reported to be low, ranging from 0.25% to 0.5%. The patient's hoarseness may initially be intermittent but can progress to complete aphonia. Unlike many cases that improve only with surgery, the patient in this report regained normal speech following her intervention, highlighting the importance of early diagnosis and treatment in preventing such complications. The study showcases that with advancements in interventional procedures, earlier management of mitral stenosis can mitigate severe symptoms and enhance patients' quality of life.
Conclusion
This case underscores the connection between mitral stenosis and atypical presentations such as Ortner's syndrome, emphasizing the need for heightened awareness of such associations in clinical practice. Mitral stenosis, if undiagnosed and untreated, can lead to serious complications, including vocal cord paralysis. However, with effective interventions like percutaneous balloon valvotomy, patients can experience significant recovery. This report serves to remind healthcare professionals of the evolving understanding of mitral stenosis management and the potential for non-surgical strategies to address the complications arising from this condition.
FAQ section (important questions/answers):
What is Ortner's syndrome and how does it relate to mitral stenosis?
Ortner's syndrome is a rare condition where hoarseness of voice occurs due to left recurrent laryngeal nerve paralysis, often associated with mitral stenosis. This is caused by compression from an enlarged pulmonary artery or left atrial enlargement.
How is mitral stenosis diagnosed in patients with hoarseness?
Diagnosis involves a thorough physical examination, echocardiography to visualize mitral valve abnormalities, and auscultation to detect characteristic heart murmurs. In this case, transesophageal echocardiography confirmed mitral stenosis and pulmonary hypertension.
What treatment options are available for mitral stenosis?
Percutaneous transvenous mitral valvotomy is a common intervention for mitral stenosis. This procedure can alleviate symptoms like hoarseness and improve heart function, as shown in the case where normal speech returned post-treatment.
What complications may arise from mitral stenosis if untreated?
Untreated mitral stenosis can lead to serious complications, including left vocal cord paralysis, dysphagia, thromboembolism, atrial fibrillation, and heart failure. Early intervention is crucial to prevent such outcomes and improve patient prognosis.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Hoarseness of Voice in a Patient with Mitral Stenosis and Ortner’s Syndrome”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Disease:
In the context of this case study, 'disease' refers to rheumatic mitral stenosis, a prevalent condition that leads to various complications, including left vocal cord paralysis due to Ortner's syndrome. Understanding the disease's manifestations is crucial for timely diagnosis and intervention, which can significantly improve patient outcomes.
2) Discussion:
'Discussion' in this text signifies the analysis and interpretation of the case, including the unique presentations of mitral stenosis like hoarseness of voice. It reflects the broader conversations in the medical community about rare complications and the importance of early detection and effective treatment options for such diseases.
3) Edema (Oedema):
'Oedema' refers to the accumulation of fluid in tissues, commonly associated with heart conditions like mitral stenosis. Although the patient presented had no peripheral oedema, it highlights the potential consequences of untreated mitral stenosis, illustrating how the disease can lead to fluid management issues in advanced stages.
4) Blood:
'Blood' is integral in diagnosing various conditions. In this case, it includes the patient's complete blood count and other relevant parameters. The results can help rule out other causes of the patient's symptoms, thereby emphasizing the importance of laboratory investigations in managing heart diseases.
5) Calculation:
'Calculation' pertains to assessing the mitral valve area based on echocardiographic parameters. This is vital to determine the severity of mitral stenosis and to decide on the appropriate intervention. Accurate calculation guides treatment planning, influencing outcomes in procedures such as percutaneous transvenous mitral valvotomy.
6) Srivastava (Sri-vastava, Shrivastava, Shri-vastava):
'Shrivastava' is mentioned in the references related to percutaneous catheter commissurotomy in rheumatic mitral stenosis. As a researcher, this contributes to a body of literature that helps clinicians understand the evolution of treatment strategies, showcasing how historical research impacts contemporary practice in managing mitral disease.
7) Nature:
'Nature' in the case report refers to the characteristics and effects of left vocal cord paralysis due to the compression of the recurrent laryngeal nerve. The nature of this complication, along with others from mitral stenosis, illustrates the diverse manifestations and the systemic impact of valvular heart disease.
8) Pulse:
'Pulse' indicates the heart rate and rhythm observed in the patient. The examination showed a regular pulse of 84/min, a critical parameter in cardiovascular assessment. Monitoring pulse is vital for diagnosing various cardiovascular issues, providing insights into cardiac function, and assessing overall patient health.
9) Fever:
'Fever' relates to the patient's history of recurrent fevers during childhood, which could indicate a previous rheumatic fever episode. Understanding fever's role in the history of rheumatic heart disease is crucial as it often plays a pivotal role in the progression to conditions like mitral stenosis.
10) Sign:
'Sign' refers to observable evidence of disease upon examination. In this case, the presence of a mid-diastolic murmur and left vocal cord paralysis are significant signs. Recognizing these signs enables clinicians to diagnose mitral stenosis promptly and implement appropriate treatment measures, improving patient outcomes.
11) Post:
'Post' in the report refers to the status of the patient after the percutaneous transvenous mitral valvotomy. Understanding post-procedure results, including the resolution of the murmur and recovery of hoarseness of voice, highlights the effectiveness of intervention in managing mitral stenosis and improving quality of life.
12) Pur (Pūr):
'Poor' in this text indicates the prognosis associated with untreated mitral stenosis. The mention of previous mortality rates emphasizes the importance of early intervention to avoid poor outcomes. By recognizing the threat posed by mitral stenosis, the medical community underscores the necessity for timely diagnosis and treatment.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Hoarseness of Voice in a Patient with Mitral Stenosis and Ortner’s Syndrome’. Further sources in the context of Science might help you critically compare this page with similair documents:
Medical treatment, Surgical intervention, Physical examination, Blood-pressure, Hoarseness of voice, Heart failure, Dysphagia, Left atrium, Early intervention, Cardiac Output, Electrocardiogram, Echocardiography, Incidental Finding, Recurrent laryngeal nerve, Atrial Septal Defect, Non surgical intervention, Congenital heart disease, Vocal cord paralysis, Cardiac Symptoms, Chest radiograph, Pulmonary hypertension, Atrial Fibrillation, Cardiac surgery, Pulmonary artery, Left atrial thrombus, Mitral stenosis, Tricuspid regurgitation, Mitral regurgitation, Pulmonary vascular resistance, Mitral valve, Patent ductus arteriosus, Exertional Dyspnea, Cardiac enlargement, Long-term outcome, Ortner's syndrome, Recurrent laryngeal nerve paralysis, Cardiovascular examination, Mitral valve disease, Left vocal cord paralysis, Pulmonary arterial trunk, Percutaneous mitral balloon valvotomy, Echocardiography confirmed, Dysphagia are uncommon complications, Normal cardiothoracic ratio, Surgical improves, Middle diastolic murmur, Audit in large, compliant left atrium, Cardiac output may become fixed, Venous pressure protect, Rehabilitation of normal speech, Arteriosclerotic heart diseases, Unilateral paralysis, Percutaneous transvenous mitral commissurotomy, Balloon mitral valvuloplasty, Percutaneous transvenous mitral valvotomy, Left vocal cord, Left ventricular failure, Heart murmur, Mitral valve area, Left atrial enlargement, Sinus rhythm, Apex beat, Diastolic murmur, Childhood rheumatic, Inoue balloon, Dysphagia megalatriensis, Paroxysmal nocturnal dyspnoea.