An 82-year-old woman presented to the ED with unintentional weight loss and progressive difficulty breathing and swallowing over several months. Her dyspnoea was worse when sitting upright. On examination, there was audible stridor at rest, (online supplemental file 1 (video)), which disappeared when she was reclined at 45°, and when flat. Neurological examination showed partial blepharoptosis and pupillary miosis on the right, findings compatible with right-sided Horner syndrome (figure 1). There was non-tender swelling of the entire right arm present (figure 2). ### Supplementary video [emermed-2021-211257supp001.MOV] Figure 1 Examination revealed right-sided Horner syndrome, with right-sided partial blepharoptosis and pupillary miosis. Figure 2 Non-tender swelling of the entire right arm, likely due to obstruction of lymphatic and venous drainage …

中文翻译：

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并发喘鸣和霍纳综合征

一名 82 岁的女性因意外体重减轻和进行性呼吸和吞咽困难数月来就诊。坐直时她的呼吸困难更严重。经检查，休息时可闻到喘鸣声（在线补充文件 1（视频）），当她以 45° 斜倚和平躺时消失。神经系统检查显示右侧部分上睑下垂和瞳孔缩小，符合右侧霍纳综合征（图 1）。整个右臂出现非压痛肿胀（图 2）。### 补充视频 [emermed-2021-211257supp001.MOV] 图 1 检查显示右侧霍纳综合征，伴有右侧部分上睑下垂和瞳孔缩小。图 2 整个右臂无压痛肿胀，