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KMID : 0374920050260010161
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Inje Medical Journal
2005 Volume.26 No. 1 p.161 ~ p.167
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A case of Vocal Cord Dysfunction Presented with Acute Dyspnea
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Hahm Cho-Rom
Lee Sung-Soon
Kim Tae-Nyun
Chin Jae-Yong
Park Hye-Yeon
Hwang Choul-Woong
Park Kyung-Il
Kim Jong-Yeon
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Abstract
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Vocal cord dysfunction (VCD) is a respiratory disorder characterized by the abnormal adduction of the vocal cords upon inspiration, expiration, or both, leading to a diverse array of acute obstructive airway signs and symptoms (wheezing, chest tightness, shortness of breath, and cough). VCD frequently mimics or confounds asthma. Misdiagnosis as asthma has led to inappropriate treatment, most notably with high-dose corticosteroids. Mistaken for anaphylaxis or angioedema, VCD has led to intubation and tracheostomy. VCD should be suspected in patients who are treated aggressively for asthma but continue to experience dyspnea.
The diagnosis of VCD is made from direct visualization of the vocal cords during an attack. Inspiratory, anterior vocal cord closure with a posterior glottic chink is seen. On pulmonary function testing, a pattern of "saw-toothing", or fluttering of the inspiratory limb, representing fluctuations in the abnormal cord motion is seen in VCD patient.
Treatment includes discussion of the diagnosis with the patients, discontinuing unnecessary medications, using of a helium-oxygen mixture in acute attack.
Speech therapy and psychotherapy are the mainstays of long-term treatment. Here in we report a case of VCD in company with asthma.
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KEYWORD
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Tocal cord, Tsthma
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