A 78-year-old man was admitted to a local physician with symptoms of hoarseness and exertional dyspnea that had begun two months earlier. He was diagnosed by contrast computed tomography (CT) image as pulmonary thromboembolism and a right lower-lobe nodule and referred to our hospital for careful examination after anticoagulant therapy. Bronchoscopy findings showed left vocal-code paralysis, and the right lower lobe nodule was pulmonary infarction by transbronchial lung biopsy findings. The chest CT image findings showed that the aortic arch and left pulmonary artery were closely contacted, and it was considered that physical pressure of the left recurrent nerve at the site was one of the causes of hoarseness. Pulmonary thromboembolism was also considered to be a cause. It resulted in a diagnosis of the Ortner syndrome, which was recurrent nerve paralysis with cardiovascular disease. We report this case because we consider it rare.