What Is Vocal Cord Dysfunction And How Is It Mistaken For Asthma?

Back in 2017, I wrote an article called “Is Your Asthma… Asthma?” about misdiagnosis of asthma. In that article, I write about a friend who had thought for years she had asthma, where it turned out she had vocal cord dysfunction, or VCD—a common but lesser-known asthma mimic. I recently had a conversation with fellow Asthma.net contributor John about this, and the experiences of two more people I know who have experienced misdiagnosis of asthma which turned out to be vocal cord dysfunction in the last couple years, and we thought it could be interesting for me to write about here.

Vocal cord dysfunction vs asthma

Vocal cord dysfunction, which may also be called paradoxical vocal ford motion (PVFM), can present a lot like asthma, except the symptoms stem from the vocal cords in your throat, rather than your lungs.¹ The symptoms that can mimic asthma include chest tightness, shortness of breath that comes and goes, and chronic cough.¹

As opposed to asthma, though, which generally affects exhalation, people with vocal cord dysfunction will have difficulty getting air IN (rather than out as is the case in asthma) and noisy inhalation—rather than wheezing when breathing out, for example.¹ They may also experience feelings like their throat is closing or that they are being “strangled," inability to speak, or voice changes (which may happen with asthma but are more likely to be linked to asthma treatments, as opposed to asthma itself²).

Like asthma, VCD symptoms may start after exposure to triggers, which can include chemical irritants or fumes, exercise, postnasal drip or allergies, and acid reflux.¹ Different to asthma, symptoms may also be triggered by voice overuse, coughing, and strong emotions.

So, we can see how it is easy for a doctor to misdiagnose asthma as VCD, as many doctors—unless they specialize in otolaryngology (AKA ear nose and throat docs)—are much more familiar with asthma than VCD! A big clue can be effectiveness of treatment like bronchodilators.

A tale of two misdiagnoses

Now, I actually know at least 5 people who have been misdiagnosed with asthma instead of vocal cord dysfunction. But because these two stories that happened in the last year or so, one of a local friend, and one of a friend online. Both were similar circumstances—they asked if they could ask me a few questions about asthma, because they were diagnosed with asthma and being treated… but their asthma treatment hadn’t been working.

Now, how my mind works as a non-medical person. Of course, I’m careful with what I say but I have a series of questions that I ask most people I learn have asthma when they want information. That way I can help point them in some semblance of a direction and I can also get a clearer picture. Have they had PFTs? What medications have they tried? How have they worked? When do they experience symptoms—have they identified triggers?

Did they have PFTS done?

Neither of my friends had PFTs done when they initially messaged me, and one clearly linked her symptoms to stress. They had been on asthma medicines—one for a long time, and one for just a few months—and had tried different things and didn’t feel they were helpful at all.

Then I told them a bit about VCD—and both of them had similar reactions.

“Oh my God. THIS sounds like what I have!”

They both went for PFTs but requested an appointment with ENT specialists to be checked for VCD. Vocal cord dysfunction, like asthma, can be tricky to diagnose because if symptoms aren’t happening, the impaired movement of the vocal cords may not be visible when scoped by the ENT. But both of my friends were rapidly diagnosed with vocal cord dysfunction during their first ENT visits.

Re-diagnosis: A relief

My friends both experienced a sense of relief with their VCD diagnosis, just like my friend in the article linked at the top of this article. VCD is usually treated with breathing exercises and speech therapy, and many people have really good results. However, sometimes vocal cord dysfunction and asthma co-exist, in which case both need to be treated effectively. VCD is said by some to be considered rare, but I’m not so sure about that; is it just under-diagnosed?

If you’re struggling with asthma symptoms and ineffective medications, it can be helpful to talk to your doctor about having pulmonary function tests done, and maybe see an ENT to evaluate for vocal cord dysfunction. You know you—my friends both read about VCD and felt it explained their symptoms better than asthma did. Maybe this article resonated with you, too, in which case, it’s worth exploring re-evaluating your diagnosis. I wish you luck!

Have you been diagnosed with vocal cord dysfunction—with or without asthma? Share about your experience in the comments!