Vocal cord dysfunction syndrome – Case report with video laryngoscopy
Presentation transcript:
- 45 years old female, a coir making worker, presented with a history of cough, choking sensations and breathlessness on exertion for 3 months.
- Disease onset, duration and progress:
- Episodic, severe, dry cough more during day associated with 3 episodes of cough syncope.
- Choking sensation at the end of cough.
- Breathlessness : MMRC Grade 1
- non-progressive.
- H/o retrosternal burning, mild epigastric pain present
- No H/o rhinitis, sneezing, urticaria.
- No H/o palpitation, orthopnea, paroxysmal nocturnal dyspnoea.
- No H/o fever, hemoptysis
- No H/s/o foreign body aspiration
- No H/o joint pain, rashes, subcutaneous nodules.
- No H/o any surgical or medical illness/ medication.
- No H/o similar complaints in the family members.
- On examination:
- Afebrile, Pulse 84/min regular, RR 20/min, regular.
- BP 120/80 mm Hg
- Oral cavity: normal
- Respiratory system:
- Shape of chest: normal
- Percussion note resonant
- Breath sound normal and B/L equal.
- Other systems: NAD
- Provisional Diagnosis:
- ? Asthma
- ? GERDS
- ? Vocal cord dysfunction
- ? Acute Left ventricular dysfunction
- ? Laryngeal edema
- Investigations:
- Blood R/E: TC 6500 cells/cmm, P:72, L:24, E: 4.
- CXR: normal
- ECG: Normal
- PFT: Flattening of the inspiratory limb with saw-tooth pattern
- Fibreoptic laryngoscopy
- Inspiratory paradoxical closing of the vocal cords with adduction of the anterior part with posterior chink remaining open
- Diagnosis:
- Vocal cord dysfunction syndrome
- Management
- Discuss the diagnosis with the patient
- Treat the underlined predisposing conditions such as GERDS
- Speech Therapy
- Treat the associated psychological disorders such as conversion disorder should be treated with counseling and Medications as required.
