RESUMO
Se define como asma de control difícil aquel que no se controla a pesar de una estrategia terapéutica adecuada habiéndose comprobado su cumplimiento, y después de descartar otras enfermedades y controlar los factores agravantes de la enfermedad. Presentamos el caso clínico de una paciente asmática de 62 años con una tórpida evolución clínica con ingresos repetidos en UCI con intubación orotraqueal. Durante el ingreso se descartaron sistemáticamente las patologías que podían simular o agravar su enfermedad hasta que se alcanzó el diagnóstico de disfunción de cuerdas vocales secundarias a reflujo gastroesofágico como factor de mal control a pesar de tratamiento médico óptimo por lo que se derivó a Cirugía General y Digestivo para valorar una actitud quirúrgica
Asthma is defined as that which is inadequately or poorly controlled despite an appropriate therapeutic strategy with a good treatment adherence. In addition, other illness and uncontrolled aggravating factors must be discarded. We present a 62-years-olds female patient that had a bad evolution with several admissions in the intensive care unit with repeated tracheal intubations. During the hospitalization, the diagnoses that could confuse or aggravate the asthma were systematically discarded. The final correct diagnosis was vocal cord dysfunction caused by gastroesophageal reflux that aggravated the asthma in spite of an optimal medical treatment so it was referred to a Digestive and General Surgeon to assess surgical treatment
