Out of Breath? Maybe it’s Not Asthma



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Out of Breath? Maybe it’s Not Asthma

Vocal Cord Dysfunction (VCD) is a relatively unknown condition that causes a student athlete shortness of breath similar to asthma. However, they are completely different and need to be treated differently. VCD occurs when the vocal cords experience abnormal adduction, or partial closing of the airway. This adduction or partial closing would make the student athlete short of breath.



Because asthma also causes shortness of breath and is so common, VCD is often misclassified as asthma. Differences between the two conditions are as follows:

Asthma Vocal Cord Dysfunction

Time of onset quick; within minutes Sudden onset: within seconds

Duration minutes to hours seconds to a few minutes

Trouble breathing during Expiration (out) Inspiration (in)

Area of limitation thorax; lower airway throat or neck

Inhaled drug therapy highly effective ineffective, aggravating

Induced by Irritants; allergens, exercise Irritants, stress, exercise

There are three main diagnostic criteria recognized for diagnosing Vocal Cord Dysfunction: clinical symptoms, laryngoscopy, and lung function tests. Management requires identifying and treating the underlying factors which cause VCD in a multidisciplinary approach. This may include pulmonologists, general internists, otolaryngologists, allergists, occupational medicine specialists, psychiatrists, speech therapists, and vocational counselors. Speech and language therapists contribute greatly in the management of VCD by identifying triggers and provide instruction in techniques of throat relaxation, cough suppression, and throat-clearing suppression. They also can teach student athletes breathing techniques, which control or reverse the adduction or closing of the vocal cords.



References:

  1. Jennifer Banfield, APRN, FNP and Kevin R. Murphy, MD. Differentiating Vocal Cord Dysfunction From Asthma. Focus on Asthma and COPD. June 2014 issue 9

  2. James T C Li, M.D. Ph. D. What’s the difference between vocal cord dysfunction and asthma? Mayo Clinic ENewsletter. August 8, 2017

  3. Dunn et al. Vocal Cord Dysfunction: a Review. Asthma Research and Practice, September 22, 2015

  4. American Academy of Allergy Asthma and Immunology. http://www.aaaai.org/conditions-and-treatments/related-conditions/vocal-cord-dysfunction author unknown




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