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Vocal cord dysfunction (VCD), or inducible laryngeal obstruction, is the abnormal adduction of the vocal cords that leads to stridor, upper airway wheezing, cough, and dyspnea. It can be misdiagnosed as asthma, but it also occurs concomitantly in as many as half of patients with asthma. It is triggered by exercise, irritants, emotional stress, and, possibly, sleep apnea and gastroesophageal reflux disease. Definitive diagnosis involves laryngoscopic examination showing paradoxical vocal-fold movement, but such examination often is not available in primary care settings.
An Australian clinic specializing in VCD and asthma reported outcomes of 212 patients who were referred for evaluation. Using spirometry with bronchodilator and direct vocal …