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Over 6 million children in our country have been diagnosed with asthma. However, a recent study conducted at Columbus Children’s Hospital found that three out of four children who appeared to have asthma actually had good oxygen levels. Instead of asthma, they suffered from vocal cord dysfunction or VCD. Misdiagnosis can occur because the symptoms are similar. When a child enters the emergency room and can’t breathe, people may readily assume that the child is having an asthma attack, and treat the child with asthma medicines and/or steroids.
However, the treatment for VCD is different from the treatment for asthma. Instead of medicines, children with VCD need to learn breathing exercises to help them cope. One child explained the symptoms of VCD like this, “My whole throat was closed. I just couldn’t skate. It was scary.”
Doctors can actually tell the difference between VCD and an asthma attack in just a few seconds by using a simple breathing test called spirometry. One researcher suggested that using the machine for a few seconds might help keep children who don’t have asthma out of the hospital. The same researcher, McCoy, also added that using the machine would prevent exposing children to medications that they don’t need.
The study only looked at 20 children who had been diagnosed with asthma. Researchers ruled out asthma in 15 of these cases, raising questions about how many other children in our country are being improperly treated for asthma. Children can suffer from both asthma and VCD, the only way to know for sure is to have emergency rooms use the spirometry breathing test before they begin treatment.
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Asthma & Kids Fact Sheet/Natl Center for Health Statistics, American Lung Association, August 2006 –
Pulse Oximetry Coupled With Spirometry in the Emergency Department Helps Differentiate and Asthma Exacerbation From Possible Vocal Cord Dysfuntion, Pediatric Pulmonology, July 2007, Volume 42 Issue 7, pages 605-609
That’s interesting. I wonder if a child with VCD would blow a low reading on a peak flow meter. If not, that might be an easy way for parents to know the difference.
- Faith
I have VCD, diagnosed when I was 17 after a year of being mistreated for out of control asthma attacks. A good webpage for VCD information is http://cantbreathesuspectvcd.com/ .
I usually avoid using the peak flow meter during a VCD attack. The closing of the vocal cords happens during inspiration, giving the feeling of having a noose or tie being tightened around the neck. Trying to take a deep breath in can be difficult or can trigger more coughing and further exacerbation of VCD symptoms. Forcing a breath out can also send me into paroxysms of coughing, which would also irritate the VCD further.
When I get a pulling feeling at my throat around where the Adam’s apple would be when I breathe in, it is almost always VCD. You can try asking the child, if they are old enough, to point to where it feels like they can’t breathe-if they point high, to the neck region around the Adam’s apple, it’s more likely VCD instead of asthma. (That can also indicate croup or an inhaled object partly occluding the windpipe, so still take proper care and precautions)
The cough of VCD tends to be more croupy or barky as opposed to an asthmatic cough and there can be a high-pitched stridor noise (like croup) on inhalation during bad attacks.
One good thing about VCD is that it is often outgrown and if not, techniques taught by a properly trained speech therapist can help give the person with VCD better control over the condition. For some children, treating gastric reflux helps stop or reduce VCD symptoms.
When an attack hits, the doctor told me to rest and try to breathe quietly using pursed lip breathing (In slowly through the nose, out slowly through pursed lips, or like breathing out through a straw).
He also told me to drink warm fluids without caffeine, to have a hot shower and to talk as little as possible.
Asthma and VCD often co-exist (I have both), so even if a VCD diagnosis is made, the child should still be re-evaluated to see if they also have asthma.