POTS, MCAS, and Pelvic Venous Disease: Dr. Alexis Cutchins on the “Bendy, Itchy, and Dizzy” Trifecta
Zebra Talks: Living Your Best Bendy LifeShow Notes
Host Dr. Libby Hinsley welcomes cardiologist Dr. Alexis Cutchins, who left Emory after 13 years to open a private practice in New York City with the goal of building a multidisciplinary center for hypermobility spectrum disorders. Dr. Cutchins describes how curiosity led her into treating patients with POTS, dysautonomia, long COVID, EDS, and MCAS, and explains that MCAS can both drive and be triggered by POTS physiology. She also explains pelvic venous disease/left iliac vein compression as a frequent contributor to pooling, reduced cerebral perfusion, and orthostatic symptoms, sometimes treated mechanically with venous stenting.
EPISODE HIGHLIGHTS: 00:00 Welcome to Zebra Talks 00:35 Meet Dr Alexis Cutchins 02:13 Why She Focuses on POTS 04:24 Leaving Emory for NYC 05:09 Building a Center of Excellence 06:40 Hypermobility in POTS Patients 07:44 MCAS and Connective Tissue Link 08:35 How MCAS Worsens POTS 12:24 Treating MCAS Stepwise 14:56 Do POTS Subtypes Matter 16:30 Tilt Table Test Debate 19:07 Stigma Around POTS Diagnosis 20:04 Stigma And Awareness 20:27 Primary Care POTS Care 20:51 Heart Rate Reassurance 22:11 MCAS Symptom Overlap 23:55 Why Mast Cells Trigger 26:04 Pelvic Venous Disease 27:51 Iliac Compression Explained 31:14 Symptoms And Red Flags 33:19 Stents And Treatment 35:39 Where To Find Dr. Cutchins 36:34 Telehealth And Wrap
EPISODE LINKS & RESOURCES: Cutchins Cardiovascular Medicine Follow Dr. Alexis Cutchins, MD on Instagram @drcutchins Follow Dr. Alexis Cutchins, MD on YouTube @DrCutchins
LINKS AND RESOURCES: Follow Libby Hinsley on Instagram @libbyhinsleypt Follow Libby Hinsley on Facebook Learn more about Libby Hinsley, How to Work with Her, or Join her Email List Leave a review on iTunes
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Host Dr. Libby Hinsley interviews pelvic floor physical therapist and author Dr. Amy Stein, founder of Beyond Basics Physical Therapy. Stein discusses the strong overlap she sees between hypermobility and pelvic floor dysfunction (estimating about 70% of her patients), including patterns of pelvic floor gripping used for stability, pelvic pain, prolapse, hernias, constipation/IBS symptoms, possible pelvic congestion, and bladder, bowel, and sexual dysfunction across all genders.