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Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
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Idiopathic subglottic stenosis and the consequences in cardiopulmonary exercise testing
Rick Verjans1, Sietske van Berkel2, Tom Brandon2
1Sports Medicine, Isala Zwolle, Zwolle, The Netherlands r.j.h.verjans@isala.nl.
BMJ Case Reports
|December 1, 2021
Summary
Idiopathic subglottic stenosis caused exercise-induced breathing difficulties in a teen. Early spirometry could have aided diagnosis, but balloon dilation ultimately resolved the condition.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
Background:
- Progressive dyspnoea and exercise-induced wheezing in adolescents warrant thorough investigation.
- Previous paediatric assessment missed significant respiratory compromise.
Observation:
- A 15-year-old male presented with severe exercise-induced hypoventilation, hypercapnia, hypoxemia, and stridor.
- Diagnostic workup included spirometry, ECG, cardiopulmonary exercise testing, and CT imaging.
Findings:
- CT revealed circular subglottic stenosis.
- Biopsies excluded malignancy and granulomatosis with polyangiitis.
- Idiopathic subglottic stenosis was diagnosed due to lack of trauma, intubation, or infection history.
Implications:
- This case highlights the importance of comprehensive respiratory evaluation in young patients with exertional symptoms.
- Timely diagnosis and intervention, such as bronchoscopic balloon dilation, can lead to full recovery.
- Idiopathic subglottic stenosis should be considered in the differential diagnosis of unexplained exercise-induced respiratory distress.
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