Vocal Cord Dysfunction Mimicking Exercise-induced Bronchospasm in Adolescents

Abstract

Vocal cord dysfunction (VCD) is a condition defined by an abnormal adduction of the vocal cords. The signs and symptoms of VCD-throat tightness, change in voice quality and airflow obstruction sufficient to cause wheezing, chest tightness, shortness of breath, and cough-are commonly associated with exercise. VCD and exercise-induced bronchospasm (EIB), the term for exacerbation of asthma associated with physical exertion, are both aggravated by exercise and characterized by dyspnea. The clinical presentation of VCD is often dramatic and its misdiagnosis as asthma, EIB, or upper airway obstruction has led to inappropriate treatment including highdose corticosteroids, intubation, and tracheostomy.1 The diagnosis of VCD is best established by observing the vocal cords through a fiberoptic rhinolaryngoscope while the patient is symptomatic.2,3