Laryngospasm can be fatal

Patient education helps in case of paroxysmal shortness of breath due to vocal cord malfunction

13.09.2009

Around 300,000 people in Germany suffer from the phenomenon of "Vocal Cord Dysfunction" (VCD) - a vocal cord malfunction that occurs like a seizure and is actually not life-threatening, but is associated with feelings of suffocation and fear of death. The pulmonologists of the German Society for Pneumology-Pneumology explain what helps those affected best
Respiratory and pulmonary medicine (pulmonology) is a branch of internal medicine that deals with the prevention, detection and specialist treatment of diseases of the lungs, bronchi, mediastinum (middle skin) and pleura (pleura and lung).
and respiratory medicine (DGP) in Werne.

Around 300,000 people in Germany suffer from the phenomenon of "Vocal Cord Dysfunction" (VCD) - a vocal cord malfunction that occurs like a seizure and is actually not life-threatening, but is associated with feelings of suffocation and fear of death for those affected. The pulmonologists of the German Society for Pneumology and Respiratory Medicine (DGP) in Werne point this out. "In patients with VCD, the neck suddenly constricts because the vocal cords cramp and close," explains Prof. Dieter Köhler from the DGP's scientific advisory board and head of the Grafschaft Abbey Lung Clinic in Schmallenberg, North Rhine-Westphalia. “There is acute shortness of breath, which is usually preceded by a coughing attack. Since the spasmodic closure of the vocal folds only lasts a few seconds or at most two to three minutes, it feels very uncomfortable and life-threatening for those affected, but it is not because it does not suffocate. After a seizure, the vocal folds open by themselves and patients can breathe normally again. About five percent of asthmatics are also familiar with such attacks, which are then often mistaken for an asthma attack that is not an asthma attack at all. As a result, the emergency sprays used for asthma cannot help them and those affected become dreaded to death. Fatal courses of a VCD are not yet known. "

Primary problem: excessive use of inappropriate medication

The causes of a VCD are still unclear. “Many factors probably come together, with a possible trigger being, for example, heartburn,” explains Köhler. “A drop of stomach acid can theoretically be enough to irritate the larynx. In such cases, heartburn medication can help. Other possible triggers - similar to asthma - are stress, psychological or physical strain, cold or warm air, cigarette smoke, room scents and perfumes as well as allergenic allergens
These are substances that are classified as "foreign" by the body's immune system and are therefore attacked, which leads to an excessive defense reaction (= allergy with hypersensitivity of the body to the respective allergen).
A distinction is made between animal, vegetable and chemical allergens, with almost any environmental substance triggering an allergy. A potential allergen is a substance that, due to its biochemical nature, can cause an allergic reaction more frequently than other substances.
 
 
 
Influences. On the other hand, the main problem with VCD is mostly due to the ignorance of the patient: Many are being prescribed more and more and stronger asthma medications which, as I said with VCD, do nothing at all and only burden those affected with undesirable side effects. "

Education, anxiety reduction, and respiratory therapy are most effective

The most effective tool in VCD is to make it clear to patients that their life is not at risk. “In order to prove to those affected that their vocal cord malfunction is actually harmless, we can consciously trigger a VCD attack during a medical examination. Of course only after prior notice, for example by touching the mucous membrane of the throat or by spraying with an anesthetic agent. The aim is then to demonstrate that despite the perceived shortness of breath, there is no danger of suffocation, because the spasm of the vocal cords will resolve itself after a short time. Special breathing therapy exercises or speech therapy advice can also be helpful in reducing the fear of death and making it easier to survive the seizures. By the way, there is also a forum for vocal cord malfunctioning association that those affected can turn to. "