Introduction Vocal Cord Dysfunction (VCD) is a poorly understood condition. It co-exists with and mimics asthma resulting in misdiagnosis and treatment of both conditions.1 To better understand this population we established a VCD registry of referrals to our VCD centre extending over a 10 year period.
Method The data recorded in the registry include patient demographics, symptoms, triggers, concomitant conditions and quality of life measures. Patients were asked to complete a questionnaire of symptoms/triggers and lung function tests were conducted.
Results Over a period of 10 years there were 476 consecutive referrals to our service with probable VCD diagnosis. N = 249 (52%) had nasendoscopy-confirmed VCD diagnosis and adequate clinical details.
Demographics – The majority of referrals were from the severe asthma clinic (150/249, 60%), Female: Male = 200:49, mean age 45 years (range 14–77), BMI Mean: 30.9kg/m2, range: 21–67.
Concomitant conditions : Gastro-oesophageal reflux 172 (69%); Globus pharyngeus 136 (55%); Rhinitis 92 (37%); Asthma 203 (82%). Spirometry: Mean actual FEV1: 2.23L (SD ± 0.86), mean FEV1% pred: 87.91 (SD ± 26.6), mean FEV1/FVC ratio = 74.5 (SD ± 13.0). Psychological status - Hospital anxiety and depression score: Anxiety: mean 11 (range 2–21); depression: mean 8 (range 0–18).
The clinical features of this population are provided in the table below.
Conclusions Patients with VCD present with a definable range of triggers and symptoms and suffer from disabling and frequent comorbidities including psychological disease which clinicians need to be aware of when managing the condition. Further work is required to define the disease natural history and long-term outcomes through establishment of a properly designed UK wide VCD registry.
Ayres JG, Mansur AH. Vocal cord dysfunction and severe asthma. American Journal of Respiratory and Critical Care Medicine 2011;184(1):2–3.