Go to Previous Page    |   Go to Next Page    |   Table of Contents

Vocal Cord Dysfunction: A Medical Condition that Mimics the Symptoms of Asthma

Asthma is commonly associated with symptoms of chest tightness, shortness of breath, coughing and/or wheezing. Although these symptoms are mostly associated with asthma, they actually may be signs of an entirely different respiratory problem. The statement "all that wheezes is not asthma" is well known to allergists, and this is particularly true of the condition known as vocal cord dysfunction (VCD) or paradoxical vocal cord adduction. Unlike asthma, vocal cord dysfunction is caused by a restriction of air flow in the upper airway resulting from sudden spasm or constriction of the vocal cords. If you suffer from vocal cord dysfunction, you usually present with symptoms of troubled breathing and/or wheezing. Since these symptoms are so similar to those of asthma, it is possible to be initially misdiagnosed as having asthma. This is why a specialist should perform a comprehensive evaluation if you are presenting with symptoms of coughing, wheezing, or shortness of breath before labeling you with the diagnosis of asthma.

Vocal cord dysfunction results in symptoms when the vocal cords pull together tightly during inspiration (breathing in), thus closing off or narrowing the passageway of the upper airway. This results in symptoms of shortness of breath and noisy breathing due to the restricted air flow, which becomes most prominent during inspiration. Although whistling sounds heard during inspiration may bear some similarity to wheezing, they have a higher pitched quality than the typical wheezing usually heard in asthma. In contrast, asthmatic wheezing is most prominent during expiration (breathing out). The sound due to vocal cord dysfunction is most prominent during inspiration (breathing in), and this sound has been termed stridor.

If you have VCD, but have been misdiagnosed with asthma, it is not surprising that you may be treated unsuccessfully with medications designed for asthma.You could be admitted to emergency rooms and even hospitalized while continuing to be misdiagnosed and treated for asthma. Failure to recognize vocal cord dysfunction often leads to usage of even more potent asthma medications (e.g. corticosteroids) in an effort to control persistent symptoms. However it should be noted that occasionally both vocal cord dysfunction and asthma can coexist. In this situation, both respiratory disorders will need to be treated simultaneously in order to fully control symptoms.

In addition to difficulty breathing, you may commonly complain of throat tightness, hoarseness and difficulty getting air in more than out. Episodes of vocal cord dysfunction often occur more during the day than at night, while poorly controlled asthma symptoms are often worse at night. Asthma inhalers, nebulizer treatments and even steroids (prednisone) do not help vocal cord dysfunction unless you also have asthma.Vocal cord dysfunction can be triggered by stress, exercise and irritants (like gas, smoke, fumes, dust, cleansing agents, pungent odors, solvents), but in many cases the cause is unknown.

Treatment usually involves working with a speech pathologist and a behavioral therapist. Occasionally Botox® injections temporarily can relax vocal cords. Surgical intervention is rarely necessary.