Introduction: Cardiovocal syndrome, or hoarseness resulting from vocal fold paralysis secondary to cardiovascular pathology, is commonly referred to as Ortner’s syndrome. We present a brief overview of vocal fold par...Introduction: Cardiovocal syndrome, or hoarseness resulting from vocal fold paralysis secondary to cardiovascular pathology, is commonly referred to as Ortner’s syndrome. We present a brief overview of vocal fold paralysis, present an illustrative case of Ortner’s syndrome, and provide a review of the pertinent literature. Here we aim to broaden one’s differential for vocal fold paralysis, discuss its importance as pertains to cardiovascular pathology and outcomes, and highlight the difficulties in therapeutic planning for these unique patients. Methods: A case report and literature review. Results: A 26-year-old female with an atrial septal defect and pulmonary hypertension presented with 5 months of hoarseness. Laryngoscopy revealed left vocal fold paralysis. Imaging from the skull base to chest showed an enlarged pulmonary artery (PA) in the absence of other abnormalities. Literature review suggests that this left laryngeal nerve paralysis results from nerve compression within the aortopulmonary window, a triangle defined by the aortic arch, PA, and ligamentumarteriosum. Imaging in our patient over 8 months demonstrated an increase in PA size from 3.9 to 4.2 cm correlating with the onset of hoarseness. Conclusions: Importantly, hoarseness second ary to laryngeal nerve compression in cardiovascular disease may correlate with a poorer prognosis, i.e., in thoracic aortic aneurysms and mitral valvestenosis. Awareness of vocal changes in the setting of cardiovascular disease improves diagnostic acumen in vocal foldparalysis.展开更多
Coronavirus disease 2019(COVID-19)caused by SARS-CoV-2 produced a global pandemic with significant mortality.As autopsies are not routinely performed on all decedents with SARS-CoV-2 infection,postmortem CT(PMCT)may b...Coronavirus disease 2019(COVID-19)caused by SARS-CoV-2 produced a global pandemic with significant mortality.As autopsies are not routinely performed on all decedents with SARS-CoV-2 infection,postmortem CT(PMCT)may be valuable to provide additional information on the cause of death and risk factors known to be associated with an increased mortality in COVID-19.The purpose of this manuscript is to review the PMCT findings in a series of 42 decedents with SARS-CoV-2 infection from our institution.Retrospective analysis of 42 decedents who had a positive postmortem nasopharyngeal swab for SARS-CoV-2 and had a PMCT were included in this study.Images were reviewed for pulmonary findings seen in COVID-19 and other organ involvement.Of the 42 decedents,although the majority had imaging findings in the lungs that would be consistent with COVID-19 and acute respiratory distress syndrome,in 14%of the decedents the SARS-CoV-2 infection was likely coincidental and the PMCT findings suggested that they died from other pathology.Over half of the decedents that died from COVID-19 had PMCT findings of vascular disease.PMCT is useful to identify pulmonary and extra pulmonary findings in decedents with SARS-CoV-2 infection that can provide additional information,which may be useful for the forensic pathologist to help determine the underlying cause of death.展开更多
文摘Introduction: Cardiovocal syndrome, or hoarseness resulting from vocal fold paralysis secondary to cardiovascular pathology, is commonly referred to as Ortner’s syndrome. We present a brief overview of vocal fold paralysis, present an illustrative case of Ortner’s syndrome, and provide a review of the pertinent literature. Here we aim to broaden one’s differential for vocal fold paralysis, discuss its importance as pertains to cardiovascular pathology and outcomes, and highlight the difficulties in therapeutic planning for these unique patients. Methods: A case report and literature review. Results: A 26-year-old female with an atrial septal defect and pulmonary hypertension presented with 5 months of hoarseness. Laryngoscopy revealed left vocal fold paralysis. Imaging from the skull base to chest showed an enlarged pulmonary artery (PA) in the absence of other abnormalities. Literature review suggests that this left laryngeal nerve paralysis results from nerve compression within the aortopulmonary window, a triangle defined by the aortic arch, PA, and ligamentumarteriosum. Imaging in our patient over 8 months demonstrated an increase in PA size from 3.9 to 4.2 cm correlating with the onset of hoarseness. Conclusions: Importantly, hoarseness second ary to laryngeal nerve compression in cardiovascular disease may correlate with a poorer prognosis, i.e., in thoracic aortic aneurysms and mitral valvestenosis. Awareness of vocal changes in the setting of cardiovascular disease improves diagnostic acumen in vocal foldparalysis.
文摘Coronavirus disease 2019(COVID-19)caused by SARS-CoV-2 produced a global pandemic with significant mortality.As autopsies are not routinely performed on all decedents with SARS-CoV-2 infection,postmortem CT(PMCT)may be valuable to provide additional information on the cause of death and risk factors known to be associated with an increased mortality in COVID-19.The purpose of this manuscript is to review the PMCT findings in a series of 42 decedents with SARS-CoV-2 infection from our institution.Retrospective analysis of 42 decedents who had a positive postmortem nasopharyngeal swab for SARS-CoV-2 and had a PMCT were included in this study.Images were reviewed for pulmonary findings seen in COVID-19 and other organ involvement.Of the 42 decedents,although the majority had imaging findings in the lungs that would be consistent with COVID-19 and acute respiratory distress syndrome,in 14%of the decedents the SARS-CoV-2 infection was likely coincidental and the PMCT findings suggested that they died from other pathology.Over half of the decedents that died from COVID-19 had PMCT findings of vascular disease.PMCT is useful to identify pulmonary and extra pulmonary findings in decedents with SARS-CoV-2 infection that can provide additional information,which may be useful for the forensic pathologist to help determine the underlying cause of death.
