Diagnostic Criteria for the Classification of Vocal Cord Dysfunction (VCD)

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Vocal cord dysfunction (VCD) is a syndrome characterized by paroxysms of glottic obstruction due to true vocal cord adduction resulting in symptoms such as dyspnea and noisy breathing.

Diagnostic Criteria for Vocal Cord Dysfunction (VCD)
Clinical symptoms

  • Prolonged symptoms
  • Recurrent, intermittent episodes
  • Shortness of breath
  • Upper airway stridor or wheezing
  • Reproducible causative or inciting factor


  • Adduction of vocal cords during inspiration or both inspiration and expiration
  • > 50% Closure of cords
  • Intermittent findings
  • May be normal when asymptomatic
  • May normalize with vocalization
  • “Posterior chinking” – variable finding

PFT (criteria for suspected VCD)

  • Normal spirometry (no response to bronchodilator)
  • Negative bronchoprovocation testing
  • Abnormal (truncated or flattened) inspiratory FVL

FVL = flow volume loop; PFT = pulmonary function testing



  1. Morris MJ, Christopher KL. Diagnostic criteria for the classification of vocal cord dysfunction. Chest. 2010 Nov;138(5):1213-23. [Medline]
  2. Deckert J, Deckert L. Vocal cord dysfunction. Am Fam Physician. 2010 Jan 15;81(2):156-9. [Medline]

Created Aug 25, 2014.