Anyone who has dealt with carpal tunnel syndrome knows the classic signs all too well. The tingling sensation and numbness in the hands that sometimes travels from the wrists up the arm can become constant. You may also experience weakness in your hands that makes it difficult to hold onto things or perform basic tasks.
More recently, doctors are noticing another—less expected—phenomenon related to carpal tunnel syndrome. In some cases, people with the condition seem to also be at higher risk of certain types of heart disease.
“In the past decade there’s been a lot of research showing a connection between people with a condition called cardiac amyloidosis who also had carpal tunnel,” says Karthikeyan Ananth, M.D., a cardiologist at Henry Ford Health. “We’re learning more and more about how and why the two conditions are related—which is important for heart disease prevention.”
How Carpal Tunnel Can Affect Your Heart
The carpal tunnel is a narrow passageway in the wrist that contains the median nerve. When this nerve is compressed, it causes the tingling and other symptoms we typically associate with carpal tunnel syndrome.
One cause of carpal tunnel is when certain abnormal protein fragments are deposited in the carpal tunnel, compressing the median nerve. “Due to either genetic or age-related abnormalities, a normal liver protein forms fragments called amyloid,” says Dr. Ananth. “We all have this protein, but in certain people it forms amyloid fragments that get deposited in various tissues in the body.”
Those same protein fragments that are deposited in the carpal tunnel can also find their way to the heart. “What we’re finding is that amyloid gets deposited in many areas of the body before it reaches the heart,” says Dr. Ananth. “On average, the diagnosis of carpal tunnel precedes a diagnosis of heart disease by about 5 to 10 years.”
When those amyloid deposits build up in the heart muscle, it can impair heart function. This can eventually lead to heart failure due to a condition called cardiac amyloidosis.
Who’s at Increased Risk of Heart Disease After Carpal Tunnel
If you have carpal tunnel—or were treated for it in the past—don’t panic. “Research shows that up to about 20% of people with carpal tunnel are later diagnosed with cardiac amyloidosis,” says Dr. Ananth. “But that means that for the vast majority of people with the condition, there is no increased risk of heart disease.”
There are a few warning signs that someone with carpal tunnel (present or past) should look out for. According to Dr. Ananth, red flags that may point to an association with cardiac amyloidosis include:
- Bilateral carpal tunnel (having it in both hands simultaneously)
- Needing carpal tunnel release surgery to treat the condition
- Having carpal tunnel plus other heart symptoms, such as atrial fibrillation (AFib) or heart failure
- Being over age 60
- Being African American
- Other orthopedic issues like spinal stenosis, trigger finger, biceps rupture, and rotator cuff, hip or knee surgery
- Neuropathy in the legs
When to See Your Doctor
The importance of the connection between carpal tunnel and heart disease is that it can help doctors diagnose cardiac amyloidosis early. That means they can treat it and help prevent it from leading to life-threatening heart failure.
“If you have (or had) carpal tunnel and also have some other heart symptoms or a family history of heart failure, you should tell your doctor,” says Dr. Ananth. “Orthopedists and cardiologists can work together to help catch this condition sooner.”
Dr. Ananth points out that if you’re about to have carpal tunnel surgery, you can talk to your surgeon about taking a biopsy of the tissue in the wrist. “It’s really easy to get that biopsy during surgery and we can use that to diagnose amyloidosis,” he says.
If you are at increased risk of cardiac amyloidosis due to carpal tunnel and other factors, it’s a good idea to consult with a cardiologist. “They can do some basic testing—like EKG and echocardiogram—to see if there’s a common theme between your symptoms,” says Dr. Ananth. “That’s a good start and can help prevent more serious problems from developing down the road.”
Reviewed by Dr. Karthikeyan Ananth, a cardiologist who specializes in general cardiology, valve disease, cardiac risk assessment and adult congenial heart disease. He sees patients at Henry Ford West Bloomfield Hospital.
