A 56-year-old woman with stress-induced hoarseness. (24th April 2012)

• Record Type: Journal Article
• Authors: Latus, Joerg; Franke, Ulrich; Alscher, M Dominik; Braun, Niko
• Is Part Of: BMJ case reports. Volume 2012
• Publication Date: 2012-04-24
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr.01.2012.5688
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A 56-year-old woman was admitted to hospital due to stress-dependent hoarseness and hypertensive urgency. The patient reported peaks of blood pressure of 210/160 mm Hg in combination with hoarseness. With indirect mirror examination, the ear-nose-and throat doctor diagnosed a paralysis of the vocal cord on the left side. The authors suspected a mass affecting the vagus nerve and performed a CT-scan with iodinated contrast material of the neck and thorax. Surprisingly the CT-scan showed an aneurysm of the aortic arch with a dilatation up to 4.8 cm, a kinking of 120° and a chronic dissection in the aneurysm. During exercise or elevated blood pressure this aneurysm expanded and made a compression of the nervus laryngeus recurrens on the left side. Thus, there is an explanation for the patient's hoarseness on exertion and during hypertensive urgency.