Is it pediatric asthma or vocal cord dysfunction? Learn to distinguish the symptoms

By: Kavita Patel, MD, Pulmonology

For many parents, the onset of cough, wheeze and shortness of breath in their child can be concerning, especially now. For many parents these symptoms indicate that their child may be experiencing an asthma attack. While these are classic symptoms of asthma, did you know the same symptoms can also be caused by an entirely different condition?

Vocal cord dysfunction (VCD) is a condition where the vocal cords, which make up the voice box, do not open the way they should. Normally, when you breathe in, your vocal cords open up and allow air to enter your windpipe and lungs. In VCD, the vocal cords move in the opposite direction, which narrows the airway leaving only a small opening for air to flow into the lungs. As a result, a person with VCD can experience shortness of breath, chest tightness, cough and wheeze. Sound familiar?

Symptoms

The symptoms of VCD typically come on suddenly and the condition occurs more often in teenagers, with girls typically being affected more than boys. Both asthma and VCD can be triggered by:

  • Exercise
  • Post nasal drip
  • Stress
  • Acid reflux
  • Tobacco smoke
  • Fumes and odors

Care and treatment

Despite their numerous similarities, the treatment of asthma and VCD widely differs. A common asthma care plan includes the use of inhaled bronchodilators (i.e. albuterol), inhaled and oral steroids and, when possible, treatment of the suspected underlying trigger.

For VCD, the mainstay of treatment is implementing breathing techniques to relax the muscles controlling the vocal cords, as well as treatment of the suspected trigger.

In our pulmonary clinics, we evaluate and provide ongoing care for many children with asthma, but sometimes asthma medications do not result in resolution of the above mentioned symptoms.  This is when an experienced pediatric pulmonologist can further evaluate and help determine if your child’s treatment should be intensified or if another condition like VCD could be the cause of their symptoms.

Furthermore, asthma and VCD can coexist in an individual, so when in doubt, call and make an appointment with a pediatric pulmonologist.

For more information about the Pulmonology program or to make an appointment online, visit texaschildrensspecialtycareaustin.org/pulmonology