Thread by @FudimMarat

Great thread on the link of Ehlers Danlos Syndrome (EDS) and Dysautonomia/POTS.

To extend on the observations some additional points 🧵:

#1 EDS is commonly associated with venous abnormalities such as nutcracker physiology of abdominal vessels or May Thurner syndrome.

https://twitter.com/AndrewCAhn2/status/1552715513859436544

#2 The issue with venous distension in the abdomen and pelvis is that it creates venous pooling/obstruction to blood return. Its mostly in the abdomen and not legs!

#3 The consequence are abdominal symptoms often reported by EDS and dysautonomia/POTS patients such as Chronic abdominal pain, Bladder fullness, Flank pain etc...

The Clinical Problem of Pelvic Venous Disorders
interventional.theclinics.com/article/S2211-…

#4 Venous pooling in the abdomen and pelvis, however also leads to so called "#CardioVenous Syndrome" also known as "#Preload-Reserve-Failure".

Extracardiac Abnormalities of Preload Reserve ahajournals.org/doi/10.1161/CI…

#5 The inability to fill the heart (preload) with blood when upright ▶️ heart "runs empty". This diminishes the amount of blood being ejected from the heart. The likely consequence:
- Chronic fatigue
- Shortness of breath
- Foggy brain sensation
- Chest pain
- Migranes
...

#6 A lot more investigations into these syndromes are needed. Greatly under-appreciated, under-tested and often mis-diagnosed. The right tests matter and more attention to the "dysautonomia" space is needed!
@Dysautonomia @manesh_patelMD @camfrazmills

ahajournals.org/doi/10.1161/CI…

#7 How long-COVID is related to the above syndromes is unclear but significant overlap in the presentation and clinical findings exists.

Autonomic dysfunction in 018long COVID019: rationale, physiology and management strategies ncbi.nlm.nih.gov/pmc/articles/P…

#8 What we do know is that to date we have many new cases of cardiovascular disease and heart failure specifically being diagnosed post-COVID hospitalization and disentangling the physiology will takes us years!

nature.com/articles/s4146…

#End