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May-Thurner syndrome in patients with postural orthostatic tachycardia syndrome and Ehlers-Danlos syndrome: a case series

BACKGROUND: Postural orthostatic tachycardia syndrome (POTS), Ehlers-Danlos syndrome (EDS), and May-Thurner syndrome (MTS) are three syndromes that are often misdiagnosed or underdiagnosed. The true prevalence of these syndromes may be higher than currently reported. The following case series is the...

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Autores principales: Ormiston, Cameron K., Padilla, Erika, Van, David T., Boone, Christine, You, Sophie, Roberts, Anne C., Hsiao, Albert, Taub, Pam R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9131024/
https://www.ncbi.nlm.nih.gov/pubmed/35620060
http://dx.doi.org/10.1093/ehjcr/ytac161
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author Ormiston, Cameron K.
Padilla, Erika
Van, David T.
Boone, Christine
You, Sophie
Roberts, Anne C.
Hsiao, Albert
Taub, Pam R.
author_facet Ormiston, Cameron K.
Padilla, Erika
Van, David T.
Boone, Christine
You, Sophie
Roberts, Anne C.
Hsiao, Albert
Taub, Pam R.
author_sort Ormiston, Cameron K.
collection PubMed
description BACKGROUND: Postural orthostatic tachycardia syndrome (POTS), Ehlers-Danlos syndrome (EDS), and May-Thurner syndrome (MTS) are three syndromes that are often misdiagnosed or underdiagnosed. The true prevalence of these syndromes may be higher than currently reported. The following case series is the first to report a three-way association between POTS, EDS, and MTS. CASE SUMMARY: We describe three patients with concomitant POTS, EDS, and MTS. Although abdominopelvic vasculature evaluation can be difficult via conventional imaging techniques, we present the use of novel dynamic contrast-enhanced magnetic resonance angiography with Differential Subsampling with Cartesian Ordering (DISCO) and four-dimensional flow magnetic resonance imaging to aid vasculature evaluation and the diagnosis of MTS. Two patients underwent left common iliac vein stenting to treat MTS, experiencing significant improvement in their POTS symptoms and quality of life. DISCUSSION: Ehlers-Danlos syndrome, POTS, and MTS may interact synergistically to exacerbate symptoms. Patients with EDS should be evaluated for possible POTS and pelvic venous complications. Left common iliac vein stenting for MTS can mitigate POTS symptoms by decreasing lower extremity venous pooling and should be considered in this patient population. Further research is needed to understand the exact mechanism and intricacies of this syndrome triad.
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spelling pubmed-91310242022-05-25 May-Thurner syndrome in patients with postural orthostatic tachycardia syndrome and Ehlers-Danlos syndrome: a case series Ormiston, Cameron K. Padilla, Erika Van, David T. Boone, Christine You, Sophie Roberts, Anne C. Hsiao, Albert Taub, Pam R. Eur Heart J Case Rep Case Series BACKGROUND: Postural orthostatic tachycardia syndrome (POTS), Ehlers-Danlos syndrome (EDS), and May-Thurner syndrome (MTS) are three syndromes that are often misdiagnosed or underdiagnosed. The true prevalence of these syndromes may be higher than currently reported. The following case series is the first to report a three-way association between POTS, EDS, and MTS. CASE SUMMARY: We describe three patients with concomitant POTS, EDS, and MTS. Although abdominopelvic vasculature evaluation can be difficult via conventional imaging techniques, we present the use of novel dynamic contrast-enhanced magnetic resonance angiography with Differential Subsampling with Cartesian Ordering (DISCO) and four-dimensional flow magnetic resonance imaging to aid vasculature evaluation and the diagnosis of MTS. Two patients underwent left common iliac vein stenting to treat MTS, experiencing significant improvement in their POTS symptoms and quality of life. DISCUSSION: Ehlers-Danlos syndrome, POTS, and MTS may interact synergistically to exacerbate symptoms. Patients with EDS should be evaluated for possible POTS and pelvic venous complications. Left common iliac vein stenting for MTS can mitigate POTS symptoms by decreasing lower extremity venous pooling and should be considered in this patient population. Further research is needed to understand the exact mechanism and intricacies of this syndrome triad. Oxford University Press 2022-04-09 /pmc/articles/PMC9131024/ /pubmed/35620060 http://dx.doi.org/10.1093/ehjcr/ytac161 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Series
Ormiston, Cameron K.
Padilla, Erika
Van, David T.
Boone, Christine
You, Sophie
Roberts, Anne C.
Hsiao, Albert
Taub, Pam R.
May-Thurner syndrome in patients with postural orthostatic tachycardia syndrome and Ehlers-Danlos syndrome: a case series
title May-Thurner syndrome in patients with postural orthostatic tachycardia syndrome and Ehlers-Danlos syndrome: a case series
title_full May-Thurner syndrome in patients with postural orthostatic tachycardia syndrome and Ehlers-Danlos syndrome: a case series
title_fullStr May-Thurner syndrome in patients with postural orthostatic tachycardia syndrome and Ehlers-Danlos syndrome: a case series
title_full_unstemmed May-Thurner syndrome in patients with postural orthostatic tachycardia syndrome and Ehlers-Danlos syndrome: a case series
title_short May-Thurner syndrome in patients with postural orthostatic tachycardia syndrome and Ehlers-Danlos syndrome: a case series
title_sort may-thurner syndrome in patients with postural orthostatic tachycardia syndrome and ehlers-danlos syndrome: a case series
topic Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9131024/
https://www.ncbi.nlm.nih.gov/pubmed/35620060
http://dx.doi.org/10.1093/ehjcr/ytac161
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