HOARSENESS IN HEART DISEASE *

LEFT recurrent laryngeal nerve palsy in association with heart disease is apparently very uncommon. Review of the literature reveals sporadic reports. We have been able to find only 30 cases in which necropsy findings are recorded. Mitral stenosis, coronary arteriosclerotic heart disease with congestive failure, and congenital heart disease with pulmonary artery dilatation are among the etiological factors reported. From a review of the literature and study of the cases herein reported it is apparent that dilatation of the pulmonary artery is the prime cause of the nerve injury. Other com-mon cardiovascular abnormalities causing left recurrent laryngeal nerve palsy (manifested by hoarseness) are aneurysm of the arch of the aorta and aneurysm of the innominate or subclavian arteries. In each of our cases the only complaint at time of hospitalization was that of hoarseness. This is significant, because it brings into focus heart disease as an important con-sideration in the differential diagnosis of that complaint. Two cases are herein reported, one with autopsy findings and the other with angiocardio