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I also observed a worsening of pre-existing POTS symptoms a condition that, in hypermobile Ehlers-Danlos Syndrome, is not incidental but mechanistically downstream: a recognized consequence of defective extracellular matrix that can produce peripheral venous laxity, impaired lower-extremity vasoconstriction, chronic hypovolemia, and the compensatory hyperadrenergic state that characterizes the neuropathic POTS phenotype

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McCullough KD, Martindale JL, Klotz LO, Aw TY, Holbrook NJ