Vocal Cord Dysfunction (VCD, breathlessness caused by a dysfunction of the vocal cords).
Vocal Cord Dysfunction (VCD) is very similar to bronchial asthma.
Vocal Cord Dysfunction (VCD), a disorder of the vocal cords which is often not properly identified, produces symptoms which are similar to those found in bronchial asthma. It is often therefore misdiagnosed as asthma, often over long periods of time, and is consequently not treated properly or effectively. Unlike the symptoms of bronchial asthma, the episodes of breathlessness which are typical of this condition may arise very quickly and are sometimes so intense that the patient experiences them as being life threatening. This, of course, has a very negative impact on the patient's quality of life.
Vocal Cord Dysfunction remains a condition which is not widely known.
VCD is certainly not a new clinical picture, however. The first descriptions of conditions of breathlessness like this can be found in the literature of the mid- nineteenth century. There remains a great deal of awareness and publicity work about this condition to be done in the future, however, because this condition, which is still not very widely known, can only be diagnosed at an early stage if the doctor making the diagnosis is familiar with the particular form of attacks of breathlessness which the patient is suffering.
Vocal Cord Dysfunction. Information from A to Z
Information. What is Vocal Cord Dysfunction (VCD)?
What is meant by Vocal Cord Dysfunction (VCD)?
The name Vocal Cord Dysfunction (VCD) does not really a very accurate description of the condition and it immediately suggests a speech disorder rather than a breathing disorder. This leads to a lot of confusion about the nature of the condition itself. ENT doctors will typically tend to think of it as being a disorder affecting the voice. Lung specialists on the other hand understand Vocal Cord Dysfunction as being a usually sudden attack of breathlessness which leads to constriction of the airways in the region of the neck and to breathlessness of varying levels of intensity. Patients affected by this conditions sometimes complain of feeling that they are not able to breathe deeply, and sometimes also that they have a feeling of breathlessness which is so severe that they feel as though they might die.
How common is vocal cord dysfunction (VCD)?
As yet there are no firm data about the frequency of this type of disorder of the vocal cords in the population as a whole. Studies of adults and children have shown, however, that at least five percent, and perhaps as much as ten percent of all patients who are thought to be suffering from bronchial asthma actually have VCD. This means that we can extrapolate that if only five percent of people who are thought to have asthma actually have VCD, there are between 250, 000 and 300,000 people in Germany who have VCD.
Vocal Cord Dysfunction (VCD) is a condition which mainly affects women.
It is mainly women who are affected by VCD. Around 75% of the patients with VCD described in the specialist literature as well as of the more than 700 patients who have now received treatment for VCD in the Schön Klinik Berchtesgadener Land, the reference centre in Germany for this condition, are female. The reasons for this are not yet understood. Great emphasis used to be placed on the fact that it was thought that it was predominantly young women who are affected by this condition. During the course of our examinations of patients at the Schön Klinik Berchtesgadener Land we have not been able to substantiate this assertion.
Causes. How develops a vocal cord dysfunction?
Physical causes of vocal cord dysfunction (VCD).
In recent years it has, however, become apparent that it is predominantly purely physical problems which may give rise to Vocal Cord Dysfunction. These include, in particular:
- Reflux symptoms (e.g. "sour eructation").
In this condition the heartburn which normally accompanies it, and which is felt above the stomach, is less significant than the reflux which is felt in the throat area (laryngo-pharyngeal reflux). Even the smallest quantities of acid or other fluids from the stomach are enough to cause the vocal cords to close up.
- Secretions from the region of the nose and the paranasal sinuses.
Excessive amounts of secretion flow down along the wall of the pharynx (pharyngeal wall) towards the vocal cords which in turn irritates the vocal cords.
Both in response to the reflux as well as to the secretions from the area around the nose (also called "post nasal drip" or "PND"), the closure of the vocal cords is a natural and very important initial defensive reflex. The area around the vocal cords represents the last line of defence for protecting the lungs from incoming fluids which could damage them.
Today experts believe that it is some form of as yet unexplained failure of this important and natural reflex action of the body which causes the condition of Vocal Cord Dysfunction. It is clear that for some reason the trigger threshold for closing up the vocal cords is lowered so that the slightest form of irritation is enough to trigger a narrowing of the airways and cause breathlessness.
Does Vocal Cord Dysfunction (VCD, breathlessness caused by a dysfunction of the vocal cords) have a psychosomatic cause?
In the first works published on this condition about 15 to 20 years ago it was mainly supposed that the condition had a psychosomatic cause. There were discussions about whether patients with the condition had particular types of personalities or whether they suffered from increased levels of anxiety or panic. There are also very frequent references to incidences of abuse in the patients' past. This may not always be related to sexual abuse what may also involve physical and/or emotional abuse.
Symtpoms. Signs of vocal cord dysfunction
What are the symptoms of vocal cord dysfunction (VCD)?
Vocal Cord Dysfunction (VCD) is characterised by attacks of breathlessness which arise very suddenly. This can happen in between normal breaths. An attack of breathlessness is often triggered by coughing. The intensity of these attacks can vary enormously: Sometimes patients may just feel that they have a little difficulty in breathing while at other times they may feel that they are going to suffocate at any minute. Vocal Cord Dysfunction is therefore often experienced by patients as being a very dangerous condition.
VCD is often found together with bronchial asthma.
About two thirds of patients with VCD also suffer from bronchial asthma. This means that in addition to suffering the problems caused by VCD they may also present the symptoms of typical bronchial asthma. This can complicate and cause confusion about the patient's condition to an extraordinary degree. This in turn can sometimes make it really difficult for a doctor to make a proper diagnosis.