Chest
Clinical InvestigationsAirways DiseaseVocal Cord Dysfunction in Patients With Exertional Dyspnea
Section snippets
Materials and Methods
Any active-duty patient between the ages of 18 and 50 years referred to the Pulmonary Disease Clinic at Brooke Army Medical Center, Fort Sam Houston, TX, for evaluation of new symptoms of exertional dyspnea was considered eligible for the protocol. Exertional dyspnea was defined as shortness of breath that occurred primarily with running, a regular part of physical training for soldiers. Any patient with an established diagnosis of pulmonary or cardiac disease was excluded from the study. All
Results
A comparison was performed of the PFT results, methacholine testing, and CPEX between three groups of patients. A total of 10 patients were considered VCD positive based on findings with direct laryngoscopy. There was agreement between the pulmonologist and speech pathologist in all cases. In the initial symptomatic evaluation group, five patients were identified: two patients had characteristic findings with both pre- and postexercise laryngoscopy, whereas the remaining three patients were
Discussion
Research over the last 2 decades has resulted in a greater understanding of laryngeal dyskinesias to include paradoxical VCD. Only in the last few years has the concept of VCD as a cause of dyspnea been generally accepted by the medical community. Our present study examined VCD in a cohort of young military patients presenting with a primary complaint of exertional dyspnea and an inability to pass a required army physical fitness test. Many of the patients were referred to our clinic with a
References (16)
- et al.
Vocal cord dysfunction: the importance of psychological factors and provocation challenge testing
J Allergy Clin Immunol
(1987) - et al.
Upper airway obstruction presenting as exercise-induced asthma
Chest
(1984) - et al.
Sensitivity and specificity of bronchial provocation testing
Chest
(1992) Glottic function and dysfunction
J Allergy Clin Immunol
(1987)- et al.
Vocal cord dysfunction: masquerader of asthma
Semin Respir Crit Care Med
(1994) - et al.
Clinical features of vocal cord dysfunction
Am J Respir Crit Care Med
(1995) - et al.
Vocal cord dysfunction presenting as asthma
N Engl J Med
(1983) - et al.
Vocal cord dysfunction masquerading as exercise-induced asthma: a physiologic cause for “choking” during athletic activities
Am J Respir Crit Care Med
(1996)
Cited by (167)
Predictors of voice therapy efficacy in vocal cord dysfunction at a tertiary care center
2023, American Journal of Otolaryngology - Head and Neck Medicine and SurgeryClinical presentation of paradoxical vocal fold motion or laryngeal dyskinesia in infants
2022, International Journal of Pediatric OtorhinolaryngologyFactors Affecting Initiation of Voice Therapy for Paradoxical Vocal Fold Motion Disorder
2020, Journal of VoiceCitation Excerpt :Another challenge in using FVLs diagnostically is that PVFM is episodic and dynamic. Even in patients with endoscopically confirmed PVFM during exertion, only 20% were found to have abnormality of the inspiratory FVL because the spirometry was administered when patients were asymptomatic.32 It is important to keep in mind several limitations inherent to our use of an outcomes database.
An unusual cause of exertional dyspnea in a 55 years old man
2020, Respiratory Medicine Case ReportsExercise-induced laryngeal obstruction: Quality initiative to improve assessment and management
2019, International Journal of Pediatric Otorhinolaryngology
No outside funding from any source was received during completion ofthe project or preparation of the manuscript.
The opinions or assertions contained herein are the private views ofthe authors and are not to be construed as reflecting the opinion ofthe Department of the Army or the Department of Defense.