Upper airway obstruction presenting as exercise-induced asthma.

A patient presented with a ten-year history of exercise-induced wheezing. After trials of metaproterenol and cromolyn failed to improve her symptoms, she was observed during exercise. She proved to have inspiratory stridor caused by collapse of the posterior aryepiglottic folds over the vocal cords during inspiration only following exercise. Symptoms primarily improved with physical conditioning. Further improvement came after treatment of her chronic rhinitis and post-nasal drip with a steroid nasal spray.