Click Here to Download this Blog Post – The Great Masquerader: Why One Glitch Can Cause 20 Different Symptoms
(Part 18)
By Dr. Nicholas L. DePace, M..D., F.A.C.C – Cardiologist specializing in autonomic dysfunction, Ehlers-Danlos syndrome and POTS.
If you have Ehlers-Danlos Syndrome (EDS) or Hypermobility Spectrum Disorder (HSD), your medical chart might look like an alphabet soup of diagnoses.
You might be seeing different specialists for:
- Fibromyalgia (chronic pain)
- POTS (Postural Orthostatic Tachycardia Syndrome)
- MCAS (Mast Cell Activation Syndrome – allergies and rashes)
- Anxiety & Panic Attacks
- IBS or Leaky Gut
It can feel like your body is falling apart in ten different ways at once. But what if these aren’t ten separate diseases? What if they are just ten different symptoms of one underlying problem?
The Root Cause: P&S Dysfunction
As we have discussed, the core issue in EDS/HSD is often a malfunction in the Parasympathetic and Sympathetic (P&S) nervous systems. When this “wiring” is faulty, it creates a domino effect that impacts almost every system in your body.
The biggest consequence of this glitch is Poor Perfusion.
- Translation: Your blood isn’t getting pumped efficiently to the top half of your body.
When your nerves don’t tighten your blood vessels correctly, gravity wins. Blood pools in your legs, leaving your brain, heart, and upper muscles starving for oxygen.
The Mystery of “Coat-Hanger Pain”
One of the most common complaints in EDS patients is a deep, aching pain that runs across the tops of the shoulders and up the back of the neck.
Doctors often call this “Coat-Hanger Pain” because the pain follows the shape of a clothes hanger.
- The Mistake: Many people think this is just “stress” or “bad posture.”
- The Reality: This is actually a sign of poor blood flow. Because your upper body isn’t getting enough blood, the muscles in your neck and shoulders essentially stiffen and cramp. It is your muscles crying out for oxygen.
The Brain’s “Panic Button” (Adrenalin Storms)
When your brain realizes it isn’t getting enough blood (poor cerebral perfusion), it goes into survival mode. It thinks you are in danger, so it slams the alarm button.
This triggers an “Adrenalin Storm.”
- Physically: You might feel sudden chest pressure, sweating, or a racing heart.
- Mentally: You feel a surge of Anxiety or a Panic Attack.
This isn’t necessarily “psychological” anxiety. It is a physiological attempt by your body to force more blood to the brain.
The Link to ADHD and Focus
This lack of blood flow can even explain cognitive struggles.
- Brain Fog: The brain is running on low battery.
- ADHD/OCD: Some researchers believe that the hyperactivity seen in conditions like ADHD (or even high-functioning Autism) might be the brain’s way of keeping itself stimulated to maintain blood flow. It is “revving the engine” to keep from stalling.
A New Way to Treat
This perspective changes everything about treatment. Instead of taking one pill for anxiety, one for pain, and one for digestion, the goal should be to treat the P&S Dysfunction first.
We have seen that when we fix the blood flow issues and calm the nervous system:
- The “Coat-Hanger” pain fades because muscles get oxygen.
- The “Anxiety” drops because the brain stops hitting the panic button.
- The “Brain Fog” lifts.
The Golden Rule: Treat the wiring first. If symptoms still persist after the blood flow is fixed, then (and only then) do we treat the specific organs.
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 centers 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.
👉 View Dr. DePace’s professional profile
👉 View medical books by Dr. DePace