If you’re one of the millions of Americans who suffer from carpal tunnel syndrome (CTS), you may want to speak to your doctor about your heart health. A new study has linked the common hand ailment to the later development of heart failure, particularly cardiac amyloidosis, a relatively rare but often fatal heart disease.
The study, which included nearly 167,000 people in the U.S., showed that those with CTS are about three times more likely than people without CTS to develop cardiac amyloidosis, also known as stiff heart syndrome. In addition, it identified that people with a genetic transthyretin (TTR) mutation have a 40 percent higher risk of developing CTS. Another study, conducted in Germany with nearly 82,000 participants, had similar findings.
Sandra Chaparro, M.D., medical director of the Advanced Heart Failure program at Baptist Health Miami Cardiac & Vascular Institute
The bottom line, says Sandra Chaparro, M.D., medical director of the Advanced Heart Failure program at Baptist Health Miami Cardiac & Vascular Institute, is that some patients with CTS could benefit from additional screenings for heart problems. “Heart failure and cardiac amyloidosis are associated with high mortality. If we can get patients early, treatment can help prevent some serious complications,” she says.
What is amyloidosis?
Amyloidosis is actually a group of diseases caused when the body produces abnormal proteins and then deposits them in places they should not be, including the skin, liver, spine and heart.
“Amyloid proteins can affect a variety of organs. The nerves of the hand and the heart tissues are common places for these proteins to build up,” Dr. Chaparro explains. Over time, as the proteins accumulate and replace normal tissue, organs begin to fail.
Patients with CTS may experience tingling, numbness and weakness in the hands and fingers because the nerve that runs through the forearm, wrist and hand can become compressed. Those with cardiac amyloidosis may have symptoms such as palpitations, fatigue, shortness of breath, excessive nighttime urination, trouble breathing when lying down and swelling of the legs, ankles or abdomen.
When deposited in the heart, the proteins can result in thickening and stiffening of the ventricular walls and, over time, the heart loses the ability to pump blood properly. In addition, irregular heart rhythms are common in patients with cardiac amyloidosis.
It can take years, however, for the increase in protein deposits in the heart to cause problems. The study suggests that the development of cardiac amyloidosis typically occurs 10 to 15 years after carpal tunnel syndrome begins and researchers say CTS could be an early warning sign. Because cardiac amyloidosis mimics so many other heart problems, it’s important to see your healthcare provider if you have any concerns.
Importance of a genetic mutation
While not everyone with CTS is at risk for cardiac amyloidosis, researchers discovered that patients with a genetic mutation known as the transthyretin mutation have a greater chance of developing familial amyloidosis polyneuropathy (FAP) and cardiac amyloidosis, Dr. Chaparro says. People with FAP have an abundance of proteins that damage the nervous system.
“Genetic testing may be advised in patients with carpal tunnel syndrome, particularly if they have any symptoms of systemic amyloidosis or have additional risk factors,” Dr. Chaparro adds.
She also suggests that patients who have CTS discuss with their physician whether amyloidosis could be the cause.
For more information about Miami Cardiac & Vascular Institute’s Heart Failure Clinic, click here.
