Laryngospasm Symptoms in Healthy Adults
Laryngospasm presents with a characteristic inspiratory "crowing" or stridor sound as the initial and most recognizable symptom, which can rapidly progress to complete airway obstruction with silent inspiration indicating total obstruction. 1, 2
Early/Partial Obstruction Symptoms
The initial presentation includes:
- Inspiratory stridor or "crowing" sound - the classic auditory hallmark of partial laryngospasm 1, 2, 3
- Marked suprasternal recession ("tracheal tug") - visible retraction above the sternum with breathing efforts 1, 2, 3
- Use of accessory respiratory muscles - recruitment of neck and chest wall muscles for breathing 1, 2, 3
- Paradoxical thoracoabdominal movements - chest and abdomen moving in opposite directions during breathing attempts 1, 2, 3
Complete Obstruction Symptoms
As obstruction worsens, the presentation changes critically:
- Silent inspiration - absence of breath sounds despite respiratory effort, indicating complete vocal cord closure 1, 2
- Severe respiratory distress - worsening work of breathing with increasing accessory muscle use 1
- Progressive hypoxia - falling oxygen saturation leading to cyanosis 1
Associated Symptoms and Complications
If laryngospasm persists without treatment:
- Post-obstructive pulmonary edema (occurs in ~4% of cases) - presents with dyspnea, agitation, cough, pink frothy sputum, and low oxygen saturations 2, 3
- Hypoxic cardiac arrest - can occur if laryngospasm is not relieved promptly 1, 2, 3
- Syncope - loss of consciousness from severe hypoxia, particularly in GERD-related laryngospasm 4
Context-Specific Presentations
In non-anesthetic settings (healthy adults):
- Acute dyspnea with stridor - sudden onset breathing difficulty with high-pitched inspiratory sound 5
- Pinching sensation in throat - may precede full laryngospasm episodes 5
- Paroxysms of coughing - episodic severe coughing fits, especially when associated with GERD 4, 6
Critical Clinical Pitfall
Complete airway obstruction presents with silent inspiration, not stridor - the absence of sound indicates total vocal cord closure and represents a life-threatening emergency requiring immediate intervention. 1, 2 This is contrary to what many clinicians expect, as worsening obstruction paradoxically becomes quieter rather than louder.