Coexistent Asthma and Functional Upper Airway Obstruction

Elshami, Ashraf A.; Tino, Gregory

doi:10.1378/chest.110.5.1358

Cited by 37 publications

(31 citation statements)

References 11 publications

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“…Only 4 case reports commented on peak airway pressures on mechanical ventilation; 2 noted normal peak airway pressures (no values given), one was reported at 22 cm H 2 O and another at 25 cm H 2 O. 30,37,75,82 In our experience, resolution of wheezing and/or stridor postintubation with normal airway pressures should prompt laryngoscopic evaluation for the presence of VCD.…”

Section: Intubationmentioning

confidence: 82%

Vocal Cord Dysfunction

Morris¹,

Allan²,

Perkins³

2006

Clinical Pulmonary Medicine

108

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Vocal cord dysfunction, a syndrome of paradoxical inspiratory closure of the vocal cords, is becoming more frequently recognized and diagnosed recently since its initial modern description 30 years ago. Initially described as single case reports, the first case series in 1983 helped to clarify the typical patient and findings of vocal cord dysfunction. Recent investigations have elucidated specific etiologies such as gastroesophageal reflux, exercise, and irritants as causative factors in addition to the numerous associated psychologic factors. Speech therapy and psychotherapy have been used extensively with vocal cord dysfunction patients, but the optimal treatment has yet to be prospectively studied. This manuscript provides a comprehensive review of the reported causative factors and treatments for vocal cord dysfunction.

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Section: Intubationmentioning

confidence: 82%

Vocal Cord Dysfunction

Morris¹,

Allan²,

Perkins³

2006

Clinical Pulmonary Medicine

108

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“…To confuse matters further, asthma and vocal cord dysfunction may co-exist in the same patient. [6][7][8] When mistaken for asthma or not considered in the differential diagnosis, vocal cord dysfunction can result in unnecessary medical treatment, morbidity and expense. 1,[9][10][11] Exercise-induced vocal cord dysfunction refers to a syndrome of paradoxical vocal cord motion during strenuous exercise.…”

Section: Introductionmentioning

confidence: 99%

Exercise-induced Vocal Cord Dysfunction Presenting as Asthma in Pediatric Patients: Toxicity of Inappropriate Inhaled Corticosteroids and the Role of Exercise Laryngoscopy

Heinle¹,

Linton²,

Chidekel³

2003

Pediatric Asthma, Allergy & Immunology

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Chevalier Jackson, M.D., noted, and it is often reiterated, that "not all that wheezes is asthma." This is often the case in pediatric patients in whom there is a broad differential diagnosis for chronic respiratory symptoms. Children and adolescents with chronic respiratory symptoms require thoughtful and complete evaluation to avoid misdiagnosis with the potential for harm due to inappropriate medical therapy. This is particularly true of patients with vocal cord dysfunction, which is a common mimic of asthma. In this report, we present the case of an adolescent female athlete with exercise-induced vocal cord dysfunction misdiagnosed as asthma. Significant adrenal suppression resulted due to high doses of inhaled corticosteroids. The diagnosis of exercise-induced vocal cord dysfunction was confirmed by performing a flexible laryngoscopy during a maximal cardiopulmonary exercise test. We review our experience with a technique of combined exercise testing and real-time flexible laryngoscopy in athletes with atypical dyspnea and discuss the potential side effects of inhaled corticosteroids in pediatric patients. (Pediatr Asthma Allergy Immunol 2003;16 [4]:215-224.)

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“…This differential diagnosis is very important, as asthma treatment will have no effect on this condition. One should be aware that EIA may coexist with VCD [62]. There is no consensus definition of VCD, but the following has been proposed: an intermittent extrathoracic airway obstruction, mainly during inspiration, leading to dyspnoea of varying intensity [63].…”

Section: Diagnosis and Differential Diagnosis Of Eia In Adolescent Atmentioning

confidence: 99%

The breathless adolescent asthmatic athlete

Kh¹

2011

European Respiratory Journal

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This article concerns physical activity and sports in asthmatic adolescents. Exerciseinduced asthma (EIA) is found in 8-10% of the normal child population and in ,35% of children with current asthma, as reported in a population-based birth cohort study.The mechanisms of EIA are related to markedly increased ventilation during exercise, which causes increased heat and water loss through respiration, leading to bronchial constriction. In athletes and especially in endurance athletes, the repeated daily physical activity during training will, over time, cause epithelial damage and increase inflammation in the respiratory mucosa. With increased exposure to environmental agents, such as as cold air in skiers and chlorine compounds in swimmers, the athlete may contract symptoms and signs of asthma and bronchial hyperresponsiveness, either worsening existing asthma or causing symptoms in a previous healthy adolescent athlete.There are several causes of breathlessness in adolescents, including EIA, vocal cord dysfunction, poor physical fitness and others, which are important to consider in the diagnostic procedure.The asthmatic athlete should follow the same guidelines for treating their asthma as an ordinary asthmatic patient, with careful consideration of the special diagnostic rules given for the use of asthma drugs in sports, especially for inhaled b 2 -agonists.

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Coexistent Asthma and Functional Upper Airway Obstruction

Cited by 37 publications

References 11 publications

Vocal Cord Dysfunction

Vocal Cord Dysfunction

Exercise-induced Vocal Cord Dysfunction Presenting as Asthma in Pediatric Patients: Toxicity of Inappropriate Inhaled Corticosteroids and the Role of Exercise Laryngoscopy

The breathless adolescent asthmatic athlete

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