Document Detail

Exercise-induced bronchoconstriction and vocal cord dysfunction: two sides of the same coin?
MedLine Citation:
PMID:  23314083     Owner:  NLM     Status:  In-Data-Review    
Patients are referred often because of self-reported symptoms of dyspnea and wheeze during exercise. The two common causes of exercise-induced dyspnea are exercise-induced bronchoconstriction (EIB) and vocal cord dysfunction (VCD). It can be extraordinarily difficult to differentiate between the two, especially because they may coexist in the same patient. EIB is caused by bronchial smooth muscle constriction in the lower airways due to the inhalation of dry air or allergens during exercise; it is associated with the release of bronchoconstricting mediators from airway cells. EIB can occur in patients with or without persistent asthma. In contrast, VCD is associated with the paradoxical adduction of the vocal cords, especially during inhalation, which may produce inspiratory stridor. VCD can be solitary or comorbid with asthma and/or EIB. EIB classically is most severe after the cessation of exercise, while VCD typically occurs during exercise and resolves quickly upon exercise cessation. However, history is not adequate to differentiate between EIB and VCD, and appropriate challenge tests and flexible laryngoscopy during exercise are often necessary for diagnosis. This article examines our current understanding of these entities and discusses the mechanism, prevalence, diagnosis, and treatment.
Kenneth W Rundell; Pnina Weiss
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current sports medicine reports     Volume:  12     ISSN:  1537-8918     ISO Abbreviation:  Curr Sports Med Rep     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101134380     Medline TA:  Curr Sports Med Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  45-50     Citation Subset:  IM    
1Pharmaxis Inc., One East Uwchlan Avenue, Suite 406, Exton, PA; 2Director of Subspecialty Resident Education Associate Director of Pediatric Respiratory Medicine Fellowship Pediatric Pulmonary Function Laboratory, Section of Pediatric Respiratory Medicine, Yale University School of Medicine, New Haven, CT.
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