Comorbidities
Comorbidities are conditions that are often found in patients along with Vascular Compression Syndromes. Further research is required to confirm if there is a causal relationship between VCS and each comorbidity.
EHLERS DANLOS SYNDROME (EDS)
EDS is a group of syndromes affecting the connective tissue (at the molecular level the extracellular matrix (ECM)). Connective tissue is found throughout the body and so symptoms can be very wide ranging.
EDS and other Connective Tissue Disorders (CTDs) have a higher than typical incidence in the Vascular Compression Syndrome (VCS) population. EDS, like Vascular Compression Syndromes, is not well understood in the general medical community and subsequently is highly underdiagnosed. The high comorbidity rate of EDS in VCS patients could be due to the effect that it has on the connective tissue of the veins. EDS potentially weakens the structural integrity of the veins, making them more susceptible to collapse and stretching.
For more information see these links:
Ehlers-Danlos Society
MAST CELL ACTIVATION SYNDROME (MCAS)
Mast Cells are an important part of the Immune System, protecting many areas of our bodies that come into contact with the outside world and helping our bodies repair themselves after injury. However, mast cells can start reacting to normal stimuli, causing a wide host of symptoms, from gastrointestinal, to skin, to breathing, to syncope/ dizziness, and so on. They are also the main cause of localized or systemic inflammation.
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Mast cells also line blood vessels, so damage to blood vessels (such as compressions) can trigger mast cells to react. This means they may play an important role in VCS disease pathology.
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MCAS is widely-accepted as a comorbidity of EDS.
For more information see these links:
Mast Attack
DYSAUTONOMIA
Dysautonomia is a dysfunction of the autonomic nervous system. The autonomic nervous system regulates all bodily functions not requiring conscious effort, including breathing, blood pressure regulation, temperature regulation, digestion, etc. In dysautonomia, these functions do not work as they should, causing symptoms such as breathlessness, rapid or slow heart rate, high or low blood pressure, extreme or insufficient perspiration, etc. It can also cause gastrointestinal issues such as slowed gut motility and gastroparesis. Small Fibre Neuropathy, which can cause burning sensations on the skin for no apparent reason, may be present. Anxiety can also be a common symptom, as the nervous system not functioning as it should can cause chemical imbalances in the brain
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The most common type of dysautonomia seen in VCS patients is Postural Orthostatic Tachycardia Syndrome (POTS). There are several types of POTS, but the most common is hypovolemic POTS, which is characterized by a rapid rise in heart beat when going from a supine to standing position. Blood pooling in the pelvis due to vein compressions and retrograde flow is thought to contribute to the body's response to increase heartrate to help normalize blood volume throughout the body
Dysautonomia is highly comorbid with MCAS and EDS.
For more information see these links:
​https://www.dysautonomiainternational.org/
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AUTO-IMMUNE DISEASES
Although less prevalent than the other 3 comorbidities listed above, auto-immune conditions are also very present in the VCS community. Auto-immune conditions include Lupus, Crohn's Disease, Sjogren's Syndrome, Graves' Disease, Addison's Diseasem Hashimoto's Disease, Rheumatoid Arthritis, Irritable Bowel Disease, etc. It is not known if there is a link between the VCS and these auto-immune conditions, but the most likely one is through the implication of immune system mediators potentially released from mast cells.
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