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Ever heard of vocal cord dysfunction?

Not many have.

Vocal cord dysfunction is a respiratory condition characterized by adduction of the vocal cords. The result is a limitation of airflow at the level of the larynx that is often mistaken for asthma. The symptoms are very similar and can actually occur alone or along with asthma.

Asthma is a chronic inflammatory disease that makes airways (bronchial tubes) particularly sensitive to irritants. This is characterized by difficulty in breathing. The symptoms of asthma include:

Coughing.

Wheezing ... a whistling or squeaky sound when you breathe.

A tight feeling in the chest.

Shortness of breath causing a feeling like you can't get enough air in or out of your lungs.

Narrowing of the air passages in the lungs and hence increased resistance to airflow.

Rapid and considerable changes in airway obstruction.

Frequent nocturnal episodes and low morning peak flow values

A person with vocal cord dysfunction on the other hand, particularly those who do not have asthma, usually display the following symptoms:

Experience an abrupt attack with a quick recovery.

Are generally able to speak during an attack, but often have a hoarse voice.

May improve when he or she pants or sings (yes, sings).

Experience more difficulty breathing in than breathing out.

The harsh, high-pitched sound of air coming into a tight airway may be heard at the throat.

May have a dry cough.

May not respond to standard asthma treatment.

Generally there are no nocturnal episodes.

It's easy to see how these two respiratory conditions might be misdiagnosed. While there are other illnesses which can also mimic the symptoms of asthma the way vocal cord dysfunction does, these are generally much rarer.

Vocal cord dysfunction is often caused by postnasal drainage or reflux disease, and will generally improve with the treatment of these conditions. Another clinical clue that it might be vocal cord dysfunction instead of asthma may be that patients often respond poorly to beta-agonists or inhaled corticosteroids.

Treatment for VCD often involves high-dose inhaled and/or systemic corticosteroids, bronchodilators, and in severe cases hospitalizations, tracheostomies and intubation.

To summarize, while the exact cause of vocal cord dysfunction is not clearly evident there are some subtle differences that distinguish it from asthma. Primarily, you'll want to note if your breathing attacks are nocturnal or not, if they respond to standard asthma treatment, and if your attacks come on suddenly followed by a quick recovery.

As always, never try to diagnose yourself. For the best treatment, keep a close eye on your symptoms and share your observations with your physician.