medical minute: respiratory distress and stridor / Vocal Cord Dysfunction

VOCAL CORD DYSFUNCTION (VCD) OR PARADOXICAL VOCAL FOLD MOVEMENT (PVFM)

Vocal Cord Dysfunction (VCD) or Paradoxical Vocal Fold Movement (PVFM) occurs when the vocal cords (voice box) do not open correctly. This disorder is also referred to as paradoxical vocal fold movement.

VCD is sometimes confused with asthma because some of the symptoms are similar.

In asthma, the airways (bronchial tubes) tighten, making breathing difficult. With VCD, the vocal cord muscles tighten, which also makes breathing difficult. Unlike asthma, VCD is not an allergic response starting in the immune system.

To add to the confusion, many people with asthma also have VCD.

Although the two may have similar triggers and symptoms, the treatment approach for VCD is very different than treatments used to manage and control asthma. This makes proper diagnosis essential.

An allergist / immunologist has specialized training and experience in the diagnosis, treatment and management of complex conditions such as asthma and VCD.

SYMPTOMS & DIAGNOSIS

Symptoms
Symptoms of VCD can include:
• Difficulty breathing
• Coughing
• Wheezing
• Throat tightness
• Hoarse voice
• Voice changes

Much like with asthma, breathing in lung irritants, exercising, a cold or viral infection, or Gastroesophageal Reflux Disease (GERD) may trigger symptoms of VCD.

Unlike asthma, VCD causes more difficulty breathing in than breathing out. The reverse is true for symptoms of asthma.

Diagnosis
Diagnosing VCD can be challenging. The history of breathing difficulties when taking in a breath, having a hoarse voice or experiencing voice changes may be very helpful to discuss with your allergist / immunologist. This may lead to further tests such as spirometry or laryngoscopy.

Spirometry is a breathing test that measures airflow. A laryngoscopy involves looking at the vocal cords through a camera attached to a flexible tube. Vocal cords should be open when taking in a breath. In some people with VCD, the vocal cords actually close instead of opening.

TREATMENT & MANAGEMENT

Many people have both VCD and asthma. Yet, the treatment approach for each is different.

Treatment for VCD typically involves activities that relax the throat muscles including:
• Speech therapy
• Deep breathing techniques

If you suffer from asthma, allergies or GERD, managing these conditions will help in treating VCD.

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