[A woman with excessive dynamic airway collapse]

'Excessive dynamic airway collapse' (EDAC) is a form of tracheamalacia, that does not affect the rings of cartilage on the anterior side of the trachea, but in which the posterior wall of the trachea collapses during inspiration and expiration.

An 80 year-old woman presented to the accident and emergency department with dyspnoea and severe inspiratory and expiratory stridor, with sudden onset a few hours previously. Following a series of investigations, she was shown to have a narrowing of the trachea, radiating from the posterior wall. The diagnosis was EDAC. Because her saturation levels were acceptable and she was otherwise well she was admitted to the intensive care unit for observation only. The symptoms disappeared within 4 days, without intervention.

EDAC is usually asymptomatic, but when symptoms arise the clinical picture is often confused with asthma, COPD or laryngeal oedema. The diagnostic gold standard is bronchoscopy. Therapy is chosen on the basis of severity of the symptoms.