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[Vocal cord dysfunction mimicking bronchial asthma].

G Leibovitch1, A Oren, R N Melmed

  • 1Dept. of Medicine, Hadassah Hospital, Mt. Scopus, Jerusalem.

Harefuah
|January 15, 1991
PubMed
Summary
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Vocal cord dysfunction, a condition causing paradoxical vocal cord adduction, can mimic asthma symptoms. Speech therapy and psychological support effectively treated a patient with persistent wheezing unresponsive to asthma medications.

Area of Science:

  • Respiratory Medicine
  • Otolaryngology
  • Pulmonology

Background:

  • Bronchial asthma is a common respiratory condition characterized by airway inflammation and bronchoconstriction.
  • Variable extrathoracic obstruction can present with symptoms similar to asthma, posing diagnostic challenges.

Observation:

  • A 19-year-old woman experienced recurrent dyspnea, wheezing, and stridor unresponsive to standard asthma treatments.
  • Pulmonary function tests indicated variable extrathoracic obstruction during wheezing episodes.
  • Fiberoptic bronchoscopy revealed paradoxical vocal cord adduction as the cause of her respiratory symptoms.

Findings:

  • The patient's wheezing and dyspnea were directly caused by the abnormal closing of the vocal cords during respiration.
  • Conventional asthma therapies, including bronchodilators and corticosteroids, were ineffective in managing her symptoms.

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Implications:

  • Vocal cord dysfunction (VCD) should be considered in the differential diagnosis of patients presenting with asthma-like symptoms, especially when refractory to treatment.
  • Speech therapy and psychological interventions can be effective non-pharmacological treatments for VCD.
  • Accurate diagnosis of VCD can prevent unnecessary asthma medication use and improve patient outcomes.