When you breathe in, your vocal cords should open, allowing air to enter easily. However, some people experience sudden episodes of involuntary adduction, or closing, of the vocal cords. This is known as Vocal Cord Dysfunction (VCD) or Paradoxical Vocal Fold Movement (PVFM).

Symptoms of VCD include the following:

• Throat tightness
• Choking sensation
• Changes in voice
• Stridor (noisy breathing)
• Difficulty breathing
• Coughing
• Wheezing

Symptoms are very similar to asthma, and to make it more confusing, many patients with vocal cord dysfunction also have asthma. However, asthma is due to inflammation in the airway bronchioles (or tubes) and is often triggered by allergies or viral infections. On the other hand, VCD is due to tightening of the vocal cords and is not due to inflammatory process. Therefore, the medications used to treat asthma, such as albuterol and inhaled steroids, are often ineffective in VCD.

Typical triggers of VCD include, exercise, strong smells or smoke, gastroesophageal reflux disease (GERD) or anxiety. Patients with VCD may also have a history of surgery in which the nerves innervating the vocal cords have been affected, such as thyroid surgery.

The diagnosis of VCD can be quite challenging. The history of sudden breathing difficulty with inhalation, voice changes, and poor response to asthma medications are consistent with VCD and can lead to further evaluation with pulmonary function tests to measure airflow or laryngoscopy, which involves direct visualization of the vocal cords.

Treatment of VCD involves recognition of the condition, speech therapy and deep breathing techniques. Management of comorbidities, such as GERD and asthma, is also important.

Allergy Partners physicians are experts in the diagnosis, care and management of asthma. But they are also experts in identifying conditions that mimic asthma, like VCD. If you or a loved one are suffering from asthma or asthma like symptoms, consult your trusted Allergy Partners physician.

 

Dr. Adrienne Tinana
Allergy Partners of Corpus Christi