Could your child's asthma diagnosis actually be a mistake? The latest research reveals that this could indeed be the case, since asthma misdiagnosis is increasingly common among children today. The reason for the confusion is that the symptoms of a childhood asthma attack can be similar to the symptoms of another, less severe, condition called Vocal Chord Dysfunction (VCD), and some medical professionals easily confuse the two. However, the manners in which both asthma and VCD attacks are caused and treated are completely different.
Childhood Asthma
Today approximately 6 million youngsters in the U.S. suffer from childhood asthma and are treated accordingly. This typically means that they have a childhood asthma management plan that includes monitoring the symptoms and using control medications to keep the illness in check, as well as fast-acting relief inhalers when an asthma attack flares.
Vocal Chord Dysfunction
While in childhood asthma an asthma attack occurs as a narrowing of the airways that makes it difficult to move air in or out of the lungs, in the case of VCD, it is the vocal cords that become obstructed, impairing airflow in a similar way, and causing a noise that sounds similar to an asthma wheeze. But while an asthma attack responds to medication that opens the airways, this treatment isn't effective for VCD. Instead, during a serious VCD attack, special exercises can be used to help the vocal chords relax.
The Latest Research
A recent study of adolescents who sought emergency care for trouble breathing found many of them looked like they were experiencing an asthma attack but they had normal oxygen levels. On further examination, it seems that some were actually suffering from VCD instead of childhood asthma.[i]
Avoiding Asthma Misdiagnosis
An easy, and effective, way for emergency room physicians to differentiate between the two conditions and avoid an asthma misdiagnosis is to use a spirometry test, which is a device used to measure air going in and out of the lungs. This procedure can identify patterns of VCD and rule out an asthma attack, so young patients presenting with symptoms can be treated most appropriately.[ii]
Some experts say that increased use of spirometry in the Emergency Department setting would cut down on the number of childhood asthma diagnoses and avoid unnecessary hospital stays.[iii]
Seek Medical Care as Needed
While recognizing VCD is important in order to most effectively treat young patients and avoid an asthma misdiagnosis, it is crucial to remind parents not to try to make the differentiation between the two conditions on their own. It is up to a trained specialist who has the training and t tools to identify the subtle differences between childhood asthma and VCD symptoms. Further, you should always remember that in a true asthma attack, the symptoms can quickly progress and can be fatal if they aren't treated in time. Therefore, you should always take any asthma-like symptoms seriously, relying on your child's asthma management plan for advice and when needed, seeking emergency medical care.
[i] Nolan PK et al. "Pulse Oximetry Coupled With Spirometry in the Emergency Department Helps Differentiate an Asthma Exacerbation From Possible Vocal Cord Dysfunction." Pediatr Pulmonol. 2007; 42: 605-609. You can access an abstract of the findings at http://www3.interscience.wiley.com/journal/114265649/abstract.
[ii] From http://www.bio-medicine.org/medicine-news-1/Study-finds-some-kids-are-being-misdiagnosed-with-asthma-253-1/
[iii] From http://www.sciencedaily.com/releases/2007/08/070830160759.htm.
