Pelvic Vein Compression in Patients Diagnosed With Postural Orthostatic Tachycardia Syndrome

Results: We identified 28 patients with POTS who had symptoms of PVI. The mean age was 31.6 years (range 18-54), and 96% were female. Doppler ultrasonography revealed venous reflux in the common femoral vein in 82% of the patients. All participants met the criteria for MTS and were referred for stenting. Additionally, 21% of those evaluated had significant bilateral iliac vein compression.

Pelvic venous insufficiency and POTS

What are the conclusions of this study? 2020
Knuttinen (et al.) concluded that “the incidence of iliac venous obstruction [in female POTS patients] may be higher than the general population”. Thus, they suggest that patients diagnosed with postural orthostatic tachycardia syndrome that have symptoms of pelvic venous insufficiency could benefit from venous outflow obstruction assessment.

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

We present a unique case series on a convergence of POTS, EDS, and MTS. Given these syndromes are often misdiagnosed or underdiagnosed, the true prevalence of this association is currently unknown. With this case series, we aim to not only bring greater visibility to the POTS, EDS, and MTS community, but also provide the medical field with advancements in knowledge and treatment of this syndrome triad. Moreover, this is the first case series on patients with concomitant POTS, EDS, and MTS.

The Tie Between POTS Syndrome and Pelvic Congestion Syndrome

While not all cases of POTS syndrome are caused by pelvic congestion syndrome, recent studies have found a closer tie between the two conditions than initially thought. We have found that many patients with POTs may have May-Thurner, venous compression syndrome, causing varicosities within the pelvis and pooling of blood. 

Radiofrequency venous ablation for symptomatic relief in postural orthostatic tachycardia syndrome: a case series

The success of RFA at treating refractory POTS symptoms in these four patients with LE venous reflux, including no adverse effects, are compelling grounds to further explore this therapy and to quantify and standardize symptom improvement assessment in a larger patient population.

PELVIC VENOUS COMPRESSION IN PATIENTS WITH POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME -Journal of the American College of Cardiology

77% of our POTS patients were diagnosed with pelvic venous compression, suggesting an association between the two diagnoses. Future studies should investigate the effect of intervention, such as stent placement, on POTS outcomes and pelvic imaging findings.

Is May-Thurner Syndrome linked to Ehlers-Danlos Syndrome and POTS? - EDS.Clinic

The condition is particularly significant in patients with connective tissue disorders, such as Ehlers-Danlos Syndrome (EDS), and those with autonomic dysfunction disorders like Postural Orthostatic Tachycardia Syndrome (POTS).