Dr Terry Gaff, a physician in northeast Indiana, recently drew attention to the increased number of vocal cord dysfunction cases among patients with poor response to optimal medical management of asthma. He highlighted other diagnoses surrounding the same, which includes anatomic defects, swelling of the larynx (voice box), nerve injury and neurological disorders, in addition to common triggers like exercise, asthma, gastroesophageal reflux disease, postnasal drip, upper or lower respiratory tract infection and irritants. Dr Gaff observed that it occurs two to three times more often in females than in males, usually among those aged between 30 to 40 years. He also recommends frequent pulmonary function testing with provocative exercise and methacholine that can diagnose vocal cord dysfunction.