Patients with paradoxical vocal cord dysfunction(PVCD) frequently present with complaints of wheezing or shortness of breath(SOB) and are frequently diagnosed with asthma and treated unnecessarily for asthma. Our study examines patients referred to a Pediatric Pulmonary Clinic for uncontrolled asthma or SOB who were diagnosed with PVCD.
We retrospectively reviewed patient charts with a diagnosis of PVCD that were seen in our Pediatric Pulmonary Clinic over a 27-month period. We reviewed twenty charts for the following parameters: age, race, SOB, insurance, spirometry, hospital admission, participation in strenuous activities, anxiety, school performance, stressors, fiberoptic bronchoscopy(FOB), and complaints during the episodes (chest pain, stridor, headache, parasthesia, hyperventilation, and dizziness).
All the patients presented with a complaint of SOB. The average age of the patients was 13.4 years old. Nineteen (95%) of the patients had private insurance. Sixteen (80%) of the patient were female and 17(85%) of the patients were Caucasian. Eight(40%) of the patients complained of stridor, parasthesias, or dizziness during the episodes. Thirteen(65%) complained of hyperventilation during the episodes. Nine(45%) of the patients were participating in sports or choir. Eleven(55%) complained of been anxious. Thirteen(65%) had known stressors such as sports, divorce, illness or moving that coincided with the onset of the complaints. Fourteen(60%) admitted to an “A” average in school. Nineteen(95%) had normal spirometry and 15(65%) had diagnostic FOB. Only 5(25%) were admitted to the hospital and 2 of those admissions were to the intensive care unit. The one patient that had asthma and PVCD was a black male.
In this study, the majority of the patients were Caucasian females with private insurance presenting with a complaint of chest pain, headache, or hyperventilation during the episodes. They were “A” students and anxious.
PVCD should be considered in adolescent Caucasian female patients presenting with complaints of asthma or SOB. This may decrease the unnecessary utilization of asthma medications in this patient population.
A. Gu, None.