Neftaly Acute Vocal Cord Dysfunction

What is Vocal Cord Dysfunction?

• Definition: Paradoxical adduction (closure) of the vocal cords during inspiration (sometimes expiration), leading to airflow obstruction at the level of the larynx.
• Often mistaken for asthma but does not respond to bronchodilators.

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???? Triggers

• Stress or anxiety
• Exercise (Exercise-Induced VCD)
• Irritants (smoke, fumes, perfumes)
• Post-nasal drip, reflux (GERD)
• Recent upper respiratory tract infection

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???? Signs & Symptoms

• Sudden onset of:
  • Inspiratory stridor (vs. expiratory wheeze in asthma)
  • Throat tightness
  • Shortness of breath
  • Hoarseness or voice changes
  • Feeling of “air hunger”
• Often resolves quickly after the episode

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❌ Not Typical of Asthma

• Normal oxygen saturation
• Clear lungs on auscultation
• Poor response to asthma meds
• Normal pulmonary function tests outside of episodes

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???? Diagnosis

• Laryngoscopy during symptoms (gold standard): Shows paradoxical vocal cord motion.
• Pulmonary Function Tests: May show flattening of inspiratory loop on flow-volume loop.
• Often a clinical diagnosis when characteristic features are pr

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