Cardiovocal syndrom arare case of hoarseness of voice

Ortner's syndrome may be overlooked and unless specifically looked for may be regarded as an idiopathic cause. The diagnostic methods currently used for investigation of recurrent laryngeal nerve palsy specially the CT scan of carina to skull base may have these inherited disadvantages. As the lowest plane of the scan is so proximal to inferior region of the aorto pulmonary window an interpreter may easily miss the aneurism unless specifically looked for. One effect of this would be under diagnosis and when spotted it would be highly inadequate to assess the heart and rest of the thoracic aorta as clearly demonstrated in our patient which needed further studies. It would be a more efficient to include the heart in the CT scans in patients with extra laryngeal   causes of left recurrent laryngeal nerve palsy at least among cardiovascular risk factors.