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Chronic hoarseness in infants can signal heart failure. Two infants with congenital heart defects experienced vocal cord paralysis due to nerve traction. Surgical heart repair restored vocal cord function, highlighting the need for cardiac evaluation in such cases.
Area of Science:
- Pediatric Cardiology
- Otolaryngology
- Congenital Heart Disease
Background:
- Chronic hoarseness is an uncommon symptom in infants.
- Congestive heart failure can rarely manifest with hoarseness in infancy.
- Vocal cord paralysis may occur secondary to nerve traction in infants with cardiac anomalies.
Abstract:
Chronic hoarseness is a rare presenting or accompanying sign of congestive heart failure in infancy. Two infants had a paralyzed left vocal cord, secondary to traction on their left recurrent laryngeal nerve. Both had significant underlying congenital heart disease (type 2 aortopulmonary window, ventricular septal defect, patent ductus arteriosus; large ventricular septal defect). After surgical repair of their congenital heart defect, both infants had normal vocal cord function. Direct laryngoscopy is necessary to diagnose the cause of persistent hoarseness in infancy. If a paralyzed left vocal cord is found, a comprehensive cardiovascular diagnostic work-up is warranted.