Some athletes may develop laryngeal obstruction during exercise. It is important to distinguish this condition from other causes of exercise-induced dyspnea such as bronchoconstriction.
Clinical features:
(1) exercise-induced dyspnea with or without wheezing
(2) obstruction of the larynx
(3) evidence of airway obstruction seen on continuous laryngoscopy
Obstruction may be:
(1) supraglottic (involving the arytenoids and supporting structures)
(2) glottic (vocal cord dysfunction, other)
Structural causes may include laryngomalacia or laryngochalacia.
The condition may be misdiagnosed as exercise-induced bronchoconstriction. A clue in these patients is that the use of asthma medications is not associated with clinical improvement.
The diagnosis can easily be missed, especially if continuous laryngoscopy is not performed.
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