Welcome back to the Internet Book of Critical Care Podcast.

I'm here with Adam Thomas and we're going to talk about vocal cord dysfunction or paradoxical

vocal cord motion or inducible or ingeal obstruction or I don't even know what to call

this thing anymore.

Don't you love medicine?

It's one thing named five different things so nobody knows what you're talking about.

It's legitimately impossible to search for it on PubMed. Yeah, too many names and then it just gets

watered down in the ether. Yeah. But vocal cord dysfunction is one of those interesting presentations

because especially in the merge, you think this is an airway obstruction. This is one of those

things we train for all the time. Man, like we're going to town. This is red alert. We got to get all our toys and all our friends ready.

But this is one of those things that is very interesting on a differential. But saying up front,

do you never go to straight to vocal cord dysfunction diagnosis. Always think worst first,

unless you know for sure this patient has vocal cord

dysfunction. Absolutely. And to make things even more complicated, like there are patients who can

have vocal cord dysfunction plus asthma. So, yeah, always be careful. So epidemiology then, Josh,

who should I suspect this in or who am I going to see it with after I've ruled out all the big,

bad and scary things? I mean, the classic teaching here is that it tends to be younger patients, oftentimes

female patients, and it has some association with psychiatric comorbidity.

That being said, some of the more recent literature points out that many patients do not

have any psychiatric comorbidity.

And it's so difficult to pin down what this thing is called or how it's defined that

I feel like this epidemiology is very squishy.

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