Click Here to Download this Blog Post – Safety First: Ruling Out the “Red Flags”
By Dr. Nicholas L. DePace, M..D., F.A.C.C – Cardiologist specializing in autonomic dysfunction, Ehlers-Danlos syndrome and POTS.
When you visit a specialist for connective tissue disorders, the first appointment might feel a bit intense. The doctor will ask about your family history, heart health, and specific symptoms.
They aren’t just being nosy. They are performing a critical safety check called a Differential Diagnosis.
The “Big Three” We Must Rule Out
Before a doctor can diagnose you with hEDS or HSD, they must first make sure you don’t have one of the rarer, life-threatening conditions. These conditions affect the aorta (the main artery from the heart) and blood vessels, so missing them is not an option.
Doctors specifically look for signs of:
- Marfan Syndrome : Known for affecting the eyes, heart valves, and aorta.
- Vascular EDS (vEDS): The type that causes organ rupture.
- Loeys-Dietz Syndrome: A condition similar to Marfan’s that affects blood vessels.
The Process of Elimination If the doctor checks your heart and history and rules these “scary” conditions out, they can breathe a sigh of relief. By eliminating the dangerous imposters, what is usually left is a hypermobility disorder like hEDS or HSD.
The Back Door Diagnosis
Interestingly, most patients don’t walk into the clinic saying, “I think my joints are too loose.” They walk in saying, “I feel dizzy, my heart races, and my stomach hurts.”
The Autonomic Connection We often diagnose hEDS backward.
- The Complaint: You come in for P&S Dysfunction (dizziness, fainting, digestion issues).
- The Investigation: We take a detailed history of your autonomic nervous system.
- The Discovery: While examining you, we notice your skin is stretchy and your Beighton Score (flexibility) is high.
We find that the loose joints (hEDS) are actually the cause of the nervous system glitches. In our experience, nearly 100% of hEDS/HSD patients struggle with this combination of loose joints and “busted wiring” (Orthostatic and P&S Dysfunction).
The Good News
This might sound overwhelming, but there is a very bright silver lining.
Unlike Marfan Syndrome or Vascular EDS, Hypermobile EDS (hEDS) has a normal life expectancy. It is a condition that affects your quality of life (pain and fatigue), not the length of your life. With the right management of your nervous system and joints, you can live a full, long life.
Where to Seek Expert Care?
It is important to seek out a clinician with expertise in EDS to make an accurate diagnosis and create a treatment plan. One of the nation’s leading dysautonomia treatment center is Franklin Cardiovascular Associates, under the direction of Nicholas DePace, MD, FACC. They are located in Sicklerville, New Jersey. franklincardiovascular.com, (856) 589-6034
About the Author
Nicholas L. DePace, MD, FACC is a board-certified cardiologist and Medical Director of Franklin Cardiovascular Associates. A graduate of the Mount Sinai School of Medicine, Dr. DePace has decades of clinical, academic, and research experience and has held faculty appointments as a Clinical Professor of Medicine, becoming one of the youngest full professors in Philadelphia at the time of his appointment.
Dr. DePace specializes in the diagnosis and treatment of autonomic nervous system dysfunction (dysautonomia), including POTS, autonomic dysfunction associated with Ehlers-Danlos syndrome (EDS), chronic fatigue, and anxiety-like conditions that are frequently misdiagnosed. He is nationally recognized for his work on parasympathetic and sympathetic (P&S) nervous system imbalance, a core mechanism underlying many complex chronic disorders.
In addition to treating patients from across the United States, Dr. DePace is a prolific clinical researcher and author of multiple nationally distributed medical textbooks published by Springer and W.W. Norton, focusing on autonomic dysfunction, mitochondrial disorders, cardiovascular disease, and mind–body medicine.
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