title: Ortner syndrome with recurrent pericardial effusion: a diagnostic and therapeutic dilemma.
abstract: Ortner syndrome is a rare condition characterized by hoarseness of voice in association with a cardiovascular disease. It is caused by compression of the left recurrent laryngeal nerve by the pulmonary artery or left atrium. Mitral stenosis is a well-recognized cause, however, a number of cardiac and non-cardiac conditions have also been described. Prognosis of Ortner syndrome depends on the underlying aetiology as well as the duration of illness. The case presented here describes a 35-year-old man with hoarseness of voice with recurrent pericardial effusion. Initially, a microbiologically proven diagnosis of tuberculous aetiology with resistance to Rifampicin was made; lack of optimum response and recurrence of pericardial effusion lead to subsequent diagnosis of metastatic adenocarcinoma. The patient responded to some extent to systemic and intrapericardial chemotherapy. Immunocompromised state associated with malignancy may predispose to infection including tuberculosis.
authors.affiliation: Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh.
authors.forename: A K M Monwarul
authors.initials: AK
authors.lastname: Islam
authors.forename: Muhammad Toufiqur
authors.initials: MT
authors.lastname: Rahman
authors.forename: Mahboob
authors.initials: M
authors.lastname: Ali
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology*; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D044963:Biopsy, Fine-Needle; D004452:Echocardiography; D005260:Female; D006338:Heart Neoplasms / Q000188:drug therapy / Q000473:pathology*; D006685:Hoarseness / Q000209:etiology; D006801:Humans; D061224:Laryngeal Nerve Injuries; D007823:Laryngeal Nerves / Q000000981:diagnostic imaging / Q000473:pathology; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D009362:Neoplasm Metastasis; D010490:Pericardial Effusion / Q000150:complications / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D020519:Pericardiocentesis / Q000379:methods; D010495:Pericarditis, Tuberculous / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014374:Tuberculin Test / Q000379:methods
chemical_list: D000970:Antineoplastic Agents; D000995:Antitubercular Agents