Exercise-induced stridor due to abnormal movement of the arytenoid area: videoendoscopic diagnosis and characterization of the "at risk" group.
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.
Fahey
John T
JT
Section of Pediatric Cardiology, Yale University School of Medicine, New Haven, Connecticut 06520-8041, USA. john.fahey@yale.edu
Bryant
Nancy Jones
NJ
Karas
David
D
Goldberg
Barry
B
Destefano
Richard
R
Gracco
L Carol
LC
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