If you have vocal cord dysfunction (VCD), your vocal cords don’t open all the way when you breathe in. This blocks your airways, and you may struggle to breathe. VCD is often misdiagnosed as asthma, which has similar symptoms. It is treatable, and preventable. You can learn to manage the symptoms, but there is no cure.
Vocal cord dysfunction (VCD) is when your vocal cords (vocal folds) close when they’re supposed to be open. Opening them is outside of your control and, because of that, you may have trouble breathing. VCD is also called inducible laryngeal obstruction, paradoxical vocal cord movement (PVFM) and laryngeal dysfunction.
Your vocal folds (cords) are inside of your larynx, which is above your trachea (windpipe). They are two bands of muscle. When you take in a breath, the vocal folds open. When you talk and they close, they each stretch towards the other until they meet in the middle, and vibrate. If you have vocal cord dysfunction, the folds move toward the middle when you breathe in and out, blocking the airway.
Vocal cord dysfunction causes asthma-like symptoms, and is often mistaken for asthma. Nearly 80% of VCD episodes are wrongly diagnosed as asthma, especially asthma caused by exercise. You can have both VCD and asthma – even episodes at the same time.
Don’t hesitate to go to the emergency department if you’re having trouble breathing. But, it’s likely that tests will show you’re getting enough oxygen even though it doesn’t feel like it. VCD can feel life-threatening, but it actually isn’t.
Most people have VCD episodes only once in a while, with mild or minor symptoms. Others have episodes that are severe or occur more frequently.
People report that they feel like they have a lump in their throat or that it’s tight. You may struggle to inhale enough air, which can be painful or cause tension. Patients also may hear noise when they are breathing in, called stridor. This is different from a wheeze when breathing out, which is more consistent with asthma.
Women experience vocal cord dysfunction more often than men. It can happen to anyone, including kids as young as eight years old, but it’s most common in women ages 20 to 40.
Individuals with VCD typically have fully mobile vocal cords. Most of the time, the vocal cords can open and close appropriately. Vocal cord paralysis is when one or both vocal cords are stuck in one position, unable to open or close. If a vocal cord is fixed closer to the middle of your airway, it may cause breathing trouble. If it’s fixed to the side of your airway, you may have trouble with you voice and trouble protecting your trachea and lungs from food and liquid when you swallow.
Experts are aware of what can trigger (start) an episode of vocal cord dysfunction, but it’s unclear what really causes it. VCD isn’t contagious.
There are several reasons why you might experience a vocal cord dysfunction episode:
No. Weather does not appear to affect VCD.
No. Experts have not noted that anything in your diet affects VCD.
No, VCD is not a sign of asthma. It doesn’t cause asthma, and asthma doesn’t cause VCD.
No, vocal cord dysfunction cannot cause sleep apnea.
Yes. Chest pain is one of the symptoms.
Diagnosing vocal cord dysfunction is difficult because it resembles asthma. Your healthcare provider may perform a variety of tests, both to rule out asthma and other issues, and to diagnose vocal cord dysfunction. Tests may include:
An allergist/immunologist. Such a healthcare provider specializes in allergies, asthma and other immunologic disorders (disorders caused by a problem with your immune system). Some specialize in VCD in addition to immunologic disorders.
You may also see any of the following healthcare providers:
The treatment you’ll receive for vocal cord dysfunction will depend on whether or not you’re in an acute (severe) episode, or not. Treatments you’ll receive during an episode may include:
Treatments you’ll receive after an episode may include:
There’s no known sleeping method that can help you manage or prevent VCD. Vocal cord dysfunction can even start when you’re asleep.
Do your best to avoid what triggers your vocal cord dysfunction. Stay away from smoke, get off problematic medications and don’t eat foods that might make your GERD worse.
One medication called ipratropium (Atrovent®) may be prescribed by your healthcare provider. If you take it before you work out, it may help prevent exercised-induced VCD.
No. There’s nothing you can change about your diet that may prevent vocal cord dysfunction.
It’s likely that you’ll have more than one episode of vocal cord dysfunction. VCD can’t be cured, but it can be managed. Remember that it’s not life-threatening.
Vocal cord dysfunction can happen repeatedly, yes. Your healthcare provider will help you prevent and/or manage VCD.
Absolutely. If you practice your exercises, take any recommended medications and avoid triggers, you’re likely to have fewer and fewer episodes of vocal cord dysfunction. VCD shouldn’t permanently interfere with your day-to-day activities.
Keep your healthcare providers up to date about your vocal cord dysfunction symptoms. Take all of your prescribed medications for VCD and for what triggers it. Attend all of your appointments with your healthcare providers.
If you’re having trouble breathing, and your breathing exercises aren’t working, don’t hesitate to go to the emergency department.
A note from Cleveland Clinic
If you’re struggling to breathe, feel like your chest is tight and there’s a lump in your throat, and traditional asthma treatments aren’t working, it’s possible that you have vocal cord dysfunction. Fortunately, after you identify the triggers and learn breathing techniques, VCD shouldn’t interfere with your everyday life.
One of the most important things to remember is that you need to practice your breathing exercises whether you’re in a vocal cord dysfunction episode or not. Train yourself to manage your vocal cords.
Finally, don’t pause if you think you need to go to the emergency department. It’s better to get treatment at the hospital than it is to wait too long and find yourself in serious trouble with asthma or another type of condition that affects your breathing.
Last reviewed by a Cleveland Clinic medical professional on 05/21/2021.
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