Recognizing Vocal Cord Dysfunction: Exercising Caution Before Intubation

Vocal cord dysfunction (VCD) is the inappropriate adduction of the vocal cords during inhalation and sometimes, exhalation. Vocal cord dysfunction is often misdiagnosed in the emergency room as asthma exacerbation or laryngeal angioedema, leading to unnecessary and potentially harmful interventions including intubation and mechanical ventilation. Based on this, it is especially important to recognize this condition early to avoid intubation, which can further worsen VCD. This case presents a 74-year-old female with a history of hypertension and colon cancer who presented to the emergency department (ED) with respiratory distress associated with stridor and wheezing. Our literature review sheds light on identifying key clinical features, physical exam findings, diagnostic tests, existing treatment options for this condition, and preventive measures to minimize its occurrence.