Due to compression of the recurrent laryngeal nerve, it can cause the hoarseness of the voice, which can also be a sign of mitral stenosis.

Due to its low frequency of occurrence, more common causes of hoarseness should be considered when suspecting left recurrent laryngeal nerve palsy (LRLN).

When considering cardiovocal syndrome, the most common historical cause is a dilated left atrium due to mitral stenosis, but other causes, including pulmonary hypertension,[2] thoracic aortic aneurysms, an enlarged pulmonary artery[3] and aberrant subclavian artery syndrome have been reported compressing the nerve.

[18] Examination includes: This correlation between hoarseness of voice and cardiac anatomic pathology was first described by Dr. Norbert Ortner in 1897 after he observed left recurrent laryngeal nerve palsy (LRLN) in three patients with left atrial enlargement secondary to mitral valve stenosis.

[20] The definition of Ortner's syndrome has since then expanded to encompass all possible causes of left recurrent laryngeal nerve palsy with cardiac etiologies.