How can you tell if it's vocal chord dysfunction or asthma?

 

 There are many things that can mimic asthma, and Vocal Cord Dysfunction (VCD) is one of them.

What is VCD?

VCD is when your vocal cords close (when they should be open). 

It can cause symptoms that are the same as asthma, and that's why it can be hard to tell if it's VCD or asthma

Symptoms include:

• Coughing
• Wheezing
• Hard time breathing 

 Sounds like asthma, right?!

Other symptoms are:

• Hoarse voice
• Throat feeling tight 
• Voice changes
  

My daughter Kitty had a rough year. Her asthma was off the charts, and nothing seemed to help. Albuterol didn't help, prednisone didn't help, none of her controller inhalers were helping. 

Even though I'm a Certified Asthma Educator, I was stumped - as was Asthma Doc.

Asthma Doc ordered a spirometry test (also called a pulmonary lung function test - or PFT). 

It showed Kitty's lungs were 150% of normal. 

Hmmm

So what could explain her asthma-like symptoms? 

Asthma Doc asked if Kitty had ever been tested for VCD. 

She had - back in high school. She was running track and cross country and would use her Albuterol before a race, but still had a hard time breathing. 

Her previous Asthma Doc (rest his soul), had diagnosed Kitty VCD and recommended speech therapy. 

Speech therapy?

Yes. The speech therapist will teach you how to breathe differently, which can relax the muscles in your throat. Sounds crazy, but it works!

Kitty completed that and seemed to be doing better. But I it looks as though she has forgotten what the therapist taught her and is back to breathing the old way.

New Asthma Doc said she could refer Kitty to a ENT (Ear, Nose and Throat specialist). She said they would put a scope and camera down Kitty's throat to see if her vocal cords were closing when they should open

Kitty looked at me like "not a chance!" 

Another way to tell if it's VCD

I remembered our first Asthma Doc taught me a little trick for seeing VCD on a spirometry graph. The computer will print out a graph that show what your lungs look like. 

The bottom of the graph (B) will show what it looks like when you INHALE. It should have a  round curve (like the bottom of an egg.) 

 

Photo from: https://www.researchgate.net/figure/Normal-flow-volume-loop_fig1_228664846

 

When you have VCD, the inhalation loop will look uneven because your vocal cords are closing when you inhale (instead of opening). 

It will look like this:

 

 

Photo from: https://www.pftforum.com/blog/vocal-cord-dysfunction/

You can see the bottom dotted line that shows what it should look like when you inhale. 

The solid irregular line above is what it looks like if you have VCD. 

If your Dr. suggests you see an ENT for a scope with a camera, and you have a gag reflex, this can be another option to see if you have VCD. 

I hope this helps explain the difference between VCD and asthma. And explains how it can be treated.

Good luck and happy breathing!