What Causes Vocal Cord Dysfunction? Symptoms, Common Triggers, and More
Key takeaways:
Vocal cord dysfunction (VCD) is a medical condition where the vocal cords tighten up and close when they should be open.
VCD can be triggered — and worsened — by stress, exercise, acid reflux, or irritants in the air.
Once diagnosed, VCD can be treated with throat exercises, speech therapy, and managing any underlying medical conditions.
It’s easy to take breathing for granted since it doesn’t usually require much effort. But there are medical conditions like vocal cord dysfunction (VCD) that can make each breath a challenge. These episodes of vocal cord dysfunction can be frightening, but are short-lived in most cases.
Let’s take a closer look at the signs and symptoms of VCD and what you can do about it.
What is vocal cord dysfunction (VCD)?
Vocal cord dysfunction happens when the vocal cords aren’t opening properly. Normally, when you take in a breath and when you exhale it, your vocal cords are open to let the air pass through. But with VCD, the vocal cords are closed when they should otherwise be open. This can make it feel like it’s difficult to breathe.
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What does vocal cord dysfunction feel like?
The symptoms will depend on the severity of the VCD and how long it lasts. Some of the more common symptoms of VCD include:
Difficulty breathing or shortness of breath
A choking feeling
Stridor or wheezing
Sensation to cough or clear your throat repeatedly
A feeling of tightness in the chest or throat
Hoarse voice
An episode of vocal cord dysfunction is typically short-lived. But sometimes vocal cord dysfunction can also cause feelings of outright panic. And this can actually make the VCD episode worse.
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VCD is often confused with asthma because they have similar symptoms. In asthma the lower part of the airway tightens causing trouble exhaling. In VCD, the upper airway tightens and inhaling is hard.
What causes VCD?
The exact cause for vocal cord dysfunction isn’t clearly understood. But VCD has been closely linked to a number of risk factors. Common triggers for VCD include:
Exercise: This is one of the most common triggers for VCD and is often confused with exercise-induced asthma.
Irritants: Strong chemicals, smoke, cold air, and dust can all cause an episode of VCD.
Stress: Panic attacks, anxiety, and depression have been linked to VCD. Treating the underlying condition can improve VCD.
Rhinosinusitis: Postnasal drip is common in people with VCD. VCD can sometimes improve when sinusitis is treated with antibiotics and antihistamines.
Gastroesophageal reflux disease (GERD): Some studies show that many people with VCD also have GERD. But treatment of GERD doesn’t always improve VCD.
Medications: Some medications can trigger passing episodes of VCD. This is more often linked to phenothiazines (like prochlorperazine).
How is VCD diagnosed?
To get a diagnosis of VCD, you may need to see a specialist like an otolaryngologist (throat specialist) or pulmonologist (lung specialist). They’ll likely ask you about your symptoms and do a complete physical exam.
VCD can be tough to diagnose because it shares many symptoms with asthma and other breathing disorders. And because an episode typically lasts a few minutes, it’s unlikely to happen when you’re at a healthcare appointment.
You may have a procedure to look at your vocal cords using a special camera and light (laryngoscopy). They may also add a medication (methacholine) to see how your airways and vocal cords respond. This will help to test if your symptoms are due to asthma or VCD.
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Your healthcare provider may also suggest a pulmonary function test. This is useful to look for any blockages to airflow when breathing in.
How do you treat vocal cord dysfunction?
Any time that you’re having trouble breathing, you should seek medical care immediately. Once you have a diagnosis of VCD, you’ll need to follow up with your healthcare provider for any new or worsening symptoms.
There aren’t any medications available that treat VCD and there’s no known cure. Treatment relies on controlling the symptoms and avoiding any triggers. Other treatment options are:
Respiratory retraining therapy (to help with breathing exercises)
Psychotherapy (for symptoms of anxiety, depression)
Speech therapy (to help with throat exercises)
Treatment for VCD often requires the careful coordination of your healthcare team. This will allow them to come up with the most effective treatment plan for your symptoms.
The bottom line
Vocal cord dysfunction (VCD) can be a scary medical condition in which the vocal cords close when they should be open to allow airflow. The temporary blockage of the airway can make it difficult to breathe, causing feelings of panic. Fortunately, episodes of VCD are usually short-lived.
Although there’s no cure, treatment involves avoiding any triggers, breathing techniques, and speech therapy. If you have had episodes of breathing trouble, let your healthcare provider know right away. They can figure out the source of your symptoms and come up with a treatment plan that’s best for you.
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References
American Academy of Allergy, Asthma, and Immunology. (n.d.). Vocal cord dysfunction.
Balkissoon, R. (2007). Vocal cord dysfunction, gastroesophageal reflux disease, and nonallergic rhinitis. Clinical Allergy and Immunology.
Deckert, J., et al. (2010). Vocal cord dysfunction. American Family Physician.
Dunn, N. M., et al. (2015). Vocal cord dysfunction: A review. Asthma Research and Practice.
