What is Vocal Cord Dysfunction (VCD)?
VCD used to be called Paradoxical Vocal Fold Movement, because the vocal cords are essentially doing the opposite to what they should be doing – they close instead of opening when you breathe (see diagrams below). Symptoms and characteristics of VCD include:
- Sporadic or recurrent symptoms of shortness of breath and/or noisy breathing, much like a wheezing quality. Frequently patients complain of a tightness or ‘choking’ feeling in the throat area, although sometimes the sensation is experienced in the chest area.
- This sensation can obviously create significant fear and anxiety.
- Symptoms are frequently confused with asthma, however VCD does not resolve with puffers.
- VCD is commonly observed in young female athletes, often triggered by exercise in the first 5 minutes, however VCD occurs in many others as well.
- Patients typically experience normal voice and breathing outside of the VCD attacks.
- While a specific cause is not known, there are a number of common triggers including: laryngospasms, chronic cough, reflux disease, laryngeal dystonia, chemical exposure, upper respiratory infections, asthma, allergies, strokes, head injuries, medications, and stress.
- In some patients, the problem is constant and severe, requiring airway intervention; in others, the problem is intermittent and relatively mild.
- A careful differential diagnosis process is critical to ensure effective treatment. A team approach is usually the most effective means of identifying the problem. A team would include pulmonologists, allergists, gastroenterologists, otolaryngologists, and speech-language pathologists.