Monday Apr 06, 2026

POTS, MCAS, and Pelvic Venous Disease: Dr. Alexis Cutchins on the “Bendy, Itchy, and Dizzy” Trifecta

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