What is Vocal Cord Dysfunction?

In 1983 physicians at the National Jewish Medical Research Center reported a new condition that may mimic asthma. This condition is called Vocal Cord Dysfunction, or VCD. VCD is associated with an abnormal closing of the vocal folds, which can lead to asthma-like symptoms, such as wheezing and difficulty breathing.

During normal breathing your vocal cords open when you breathe in (inhale). However, with Vocal Cord Dysfunction the vocal cords constrict and remain close together when you inhale. This leaves only a small opening for air to flow into your lungs.

VCD is difficult to diagnose, but if not treated properly, it may lead to emergency room visits and hospitalizations. To complicate matters, some people may have a combination of asthma and Vocal Cord Dysfunction.

What are the main symptoms of VCD?

• Chronic cough.
• Shortness of breath.
• Difficulty breathing.
• Chest tightness.
• Throat tightness.
• Difficulty "getting air in."
• Hoarseness and wheezing.

VCD and asthma may have similar triggers.

• Upper respiratory infections.
• Post-nasal drip.
• Fumes, smoke, odors.
• Singing.
• Exercise.
• Emotional Upsets.
• Some triggers may be unknown.

How is VCD Diagnosed and Treated?

*Diagnostics

• Your physician may find that your symptoms do not improve as should be expected with asthma medications.
• Breathing tests may be normal and not show signs of asthma.
• A specific breathing test called a flow volume loop can help to show VCD, particularly on the inspiratory "breathing in" part of the loop, but only during VCD symptoms.
• A laryngoscopic exam may be helpful in diagnosing VCD. During this test a flexible tube equipped with a light and lens is used to visualize vocal cord movement, preferably during VCD symptoms.
• Other tests may be done to try to trigger VCD symptoms, but it is important to remember that symptoms cannot be produced voluntarily.

*Treatment

• Your physician directs the treatment planning for VCD, including any prescriptions for medication or therapy.
• The treatment team may include a speech pathologist who will provide exercises and relaxation strategies to help relieve VCD.

*Speech Therapy

• Speech therapy is a very important part of the treatment program for VCD.
• Special exercises are provided to increase your awareness and efficient use of the respiratory cycle.
• You will also learn throat relaxation exercises to practice when you are not having symptoms, so that you can use them effectively during VCD episodes.
• Counseling will be provided to help you identify and deal positively with any stress that may be an underlying factor in VCD.