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Clinical features of vocal cord dysfunction

K B Newman1, U G Mason, K B Schmaling

  • 1Department of Medicine, National Jewish Center for Immunology and Respiratory Medicine, University of Colorado Health Sciences Center, Denver, USA.

American Journal of Respiratory and Critical Care Medicine
|October 1, 1995
PubMed
Summary

Vocal cord dysfunction (VCD) often mimics asthma, frequently coexisting with it. This condition involves paradoxical vocal cord motion, leading to significant misdiagnosis and high healthcare utilization.

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Area of Science:

  • Respiratory Medicine
  • Otolaryngology
  • Pulmonology

Background:

  • Vocal cord dysfunction (VCD) is a laryngeal condition causing airflow limitation.
  • Previously, VCD was primarily documented in case reports and small patient series.
  • Understanding VCD's clinical features and its relationship with asthma is crucial for accurate diagnosis.

Purpose of the Study:

  • To review and statistically analyze demographic, historical, physiologic, laboratory, and psychiatric factors in hospitalized patients diagnosed with VCD.
  • To define the historical and clinical features of VCD.
  • To investigate the overlap and misdiagnosis of VCD as asthma.

Main Methods:

  • Retrospective review of all patients hospitalized between 1984 and 1991 with a VCD diagnosis.

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  • Statistical analysis of demographic, historical, physiologic, laboratory, and psychiatric data.
  • Laryngoscopic confirmation of paradoxical vocal cord motion.

    • Main Results:

    • Ninety-five patients met criteria for VCD; 53 also had asthma.
    • VCD without asthma predominantly affected young women, often misdiagnosed as asthma for nearly 5 years.
    • Patients with VCD experienced high healthcare utilization, including frequent emergency room visits and hospital admissions, with 28% requiring intubation.

    Conclusions:

    • VCD can present as or coexist with asthma, leading to misdiagnosis.
    • Defining the clinical and historical characteristics of VCD is essential for improving patient outcomes.
    • VCD diagnosis requires careful evaluation to differentiate it from or identify its presence alongside asthma.