Vocal Cord Dysfunction (VCD) is often mistaken for asthma since they both share similar triggers and symptoms. Have you ever had a time when you could get breath out, but not in? Have you had symptoms that you thought were asthma? Read on to learn what VCD is, how it differs from asthma, and how it's treated.

What is Vocal Cord Dysfunction?
Paradoxical Vocal Fold Motion (PVFM), commonly called Vocal Cord Dysfunction (VCD), is a condition of the vocal cords. Due to similar signs and symptoms, VCD is often confused with asthma, making it a tricky condition to diagnose. Let’s take a look at the vocal cords and how they work.

Vocal Cord Functions
The vocal cords (vocal folds) are found at the top of the trachea and are used to create sounds (talking, singing, yelling, etc.). Vocal folds are comprised of two infoldings of mucus membrane, which is stretched horizontally across the larynx (voice box). These membranes vibrate when air is exhaled, producing noises and sounds. Inhaling and exhaling cause the vocal cords to open and allow air flow through the wind pipe and into the lungs.

VCD causes the vocal cords to close together during breathing, causing a constriction that leaves a very small opening for air to flow through and causing symptoms similar to asthma.

VCD Triggers
VCD and asthma can have similar triggers, including the following:

• Respiratory infections
• Post-nasal drip
• GERD
• Strong odors and perfumes
• Smoke (cigarette, fire places, etc.)
• Exercise
• Laughing
• Singing
• Laryngopharyngeal reflux (LPR)
• Environmental changes (cold air, change in temperature and/or humidity)
• Strong emotions
• Stress
• Anxiety
• Tension
• Exposure to pollution, chemicals, allergens

VCD Signs and Symptoms
Vocal cord dysfunction can be scary and even dangerous. Patients who have VCD may experience these symptoms:

• Feeling short of breath (hard to get air into or out of your lungs)
• Chest tightness
• Throat tightness
• Cough and clearing their throat
• Feelings of suffocation or choking
• Noisy breathing (wheezing or raspy sound)
• Hoarse voice (may be intermittent)

A VCD attack can come on all of a sudden and can even be severe. A severe attack may require emergency room treatment. One note, during a vocal cord dysfunction attack your blood oxygen level is typically normal. In addition, VCD doesn't usually happen during sleep. On the other hand, blood oxygen level does go down during an asthma attack, and there is a form of asthma (nocturnal asthma) that does strike during sleep.

Tests for VCD
VCD is often confused with asthma, anaphylaxis, collapsed lungs and other breathing conditions. Some VCD patients are first diagnosed as having asthma, but then treatment with asthma medications does not work and vocal cord dysfunction becomes a possible diagnosis. Making diagnosis even more difficult is the fact that about 40% of asthma patients also have VCD.

Your doctor will take a detailed history of your symptoms and may order tests to rule out other conditions. VCD is typically diagnosed with laryngoscopy and spirometry.

During a laryngoscopy (an outpatient test) procedure, a laryngoscope (flexible scope) is passed through your nose, down the back of your throat to your vocal cords. Your nose and throat are usually numbed before the scope is put into your nose. During the test, you may be required to exercise on a treadmill or sing/talk. A technician or specialist will watch your vocal cords on a monitor to see how they open and close. In addition, you may be given a medication called methacholine in order to bring on VCD symptoms.

How is Vocal Cord Dysfunction Treated?
VCD can be treated with two different approaches: a medical and/or a behavioral approach. It may be necessary to use both approaches, depending on any underlying medical conditions that may be contributing to your vocal cord condition.

Medical treatment for vocal cord dysfunction will involve taking medications for any underlying medical conditions, such as GERD, LPR, allergies, post nasal drip and asthma.

Behavioral treatment for vocal cord dysfunction is taught by a speech therapist or other breathing specialist, and may include the following:

• Increase awareness of breathing
• Correction of breathing patterns
• Awareness of posture and relaxation of throat muscles
• Control of VCD during exercise
• Cough suppression techniques
• Elimination of throat clearing

The Goal of VCD Treatment
VCD doesn’t have to ruin your life. With proper diagnosis and treatment, you can learn to manage and/or eliminate vocal cord dysfunction.