Whereas asthma is a disease of inflammation of the lower airway, vocal cord dysfunction is a disease involving inflammation of the larynx or upper airway. Symptoms of vocal cord dysfunction can often mimic asthma. Patients describe shortness of breath with exercise, shortness of breath when lying flat, tightening of the throat, an inability to take a deep or full breath, and inspiratory wheezing. Symptoms can sometimes be frightening and can mimic those of a panic attack, resulting in a misdiagnosis.
There are four predominant causes of vocal cord dysfunction. These include acid reflux, postnasal drip, occupational exposure, and/or inflamed nerves that effect the larynx. Some experts have described this as a fibromyalgia of the larynx. Diagnosis is often made based on clinical history, and can be confirmed with tests such as a flow-volume loop, which we perform in our office, or laryngoscopy.
It is possible to have both asthma and vocal cord dysfunction. A diagnosis usually involves understanding the etiology of vocal cord dysfunction and then recommending a course of treatment accordingly. Generally, lifestyle recommendations are given to address acid reflux, as well as medications to suppress acid temporarily and allow for healing. Diagnosing and treating upper airway diseases by addressing environmental triggers as well as using appropriate medications can significantly improve symptoms. How a patient responds to therapy determines the need for further medications and treatment.