title: Exercise-induced stridor due to abnormal movement of the arytenoid area: videoendoscopic diagnosis and characterization of the "at risk" group.
abstract: We evaluated 4 patients who developed severe, symptomatic stridor during maximal cardiopulmonary exercise testing, all referred due to exercise-related dyspnea. All underwent resting, unsedated transnasal fiberoptic laryngoscopy and had normal findings. Four patients performed repeat maximal exercise testing with fiberoptic laryngoscopy, and they form the basis of this report. They had normal vocal cord motion during exercise, but developed abnormal anterior motion of the arytenoid and aryepiglottic folds only at peak exercise, leading to partial airway obstruction and severe stridor. This report details the workup and characterizes patients at risk for this unusual phenomenon.
authors.affiliation: Section of Pediatric Cardiology, Yale University School of Medicine, New Haven, Connecticut 06520-8041, USA. john.fahey@yale.edu
authors.forename: John T
authors.initials: JT
authors.lastname: Fahey
authors.forename: Nancy Jones
authors.initials: NJ
authors.lastname: Bryant
authors.forename: David
authors.initials: D
authors.lastname: Karas
authors.forename: Barry
authors.initials: B
authors.lastname: Goldberg
authors.forename: Richard
authors.initials: R
authors.lastname: Destefano
authors.forename: L Carol
authors.initials: LC
authors.lastname: Gracco
mesh_terms: D000293:Adolescent; D000328:Adult; D001193:Arytenoid Cartilage / Q000002:abnormalities* / Q000502:physiology; D004825:Epiglottis / Q000002:abnormalities / Q000502:physiology; D015444:Exercise; D005080:Exercise Test; D005260:Female; D006801:Humans; D007828:Laryngoscopy; D012135:Respiratory Sounds / Q000209:etiology*; D012307:Risk Factors; D014741:Video Recording; D014827:Vocal Cords / Q000002:abnormalities* / Q000502:physiology