Could Your Carpal Tunnel Symptoms Indicate a Hidden Heart Condition Called ATTR? What You Need To Know

Symptoms of carpal tunnel syndrome are a common early sign in people with a potentially serious heart condition called transthyretin amyloidosis (ATTR). However, carpal tunnel is much more common than ATTR, so most cases of carpal tunnel are not related to ATTR.

To understand how conditions can be connected, you need to know a little more about each condition:

What is carpal tunnel syndrome? The disease develops when something, such as swelling of the tissues around the nerve, compresses the nerve that passes through the space between the wrist bones. This causes symptoms such as pain, numbness, and tingling in the hand. Carpal tunnel syndrome affects approximately 1-5% of people.

What is ATTR? It’s a kind of amyloidosis. In amyloidosis, proteins do not fold properly into the correct shape. For this reason, they produce abnormal clumps and fibers. They get stuck in parts of the body where they don’t belong, interfering with normal activities. With ATTR, it is the transthyretin protein that clumps together. ATTR can be a genetic condition that you inherit, but not always.

How ATTR can lead to carpal tunnel: In ATTR, abnormal fibers most often affect your heart and nerves. Sometimes abnormal ATTR fibers affect the nerve in your wrist, causing symptoms of carpal tunnel syndrome.

Yes, carpal tunnel syndrome can be the first sign of transthyretin amyloidosis. About half of people with heart problems due to ATTR experience carpal tunnel symptoms. These symptoms usually appear about 5 to 15 years before any heart problem is diagnosed.

If you have carpal tunnel syndrome, the risk of later being diagnosed with ATTR is approximately tthree times higher compared to someone who does not have carpal tunnel syndrome. However, the overall risk of developing amyloidosis is still very low. For most people, carpal tunnel is NOT a sign of ATTR.

Still, experts have been thinking about how people with carpal tunnel might need to be screened for ATTR. Indeed, ATTR can be serious and treatment is more effective with early diagnosis. Thus, screening people with carpal tunnel syndrome for ATTR could lead to earlier diagnosis and better outcomes for ATTR.

If you have symptoms that may be from carpal tunnel, see your primary care provider. Symptoms such as pain and tingling in the hand and fingers may be from carpal tunnel syndrome, although they could be from something else. Your provider can determine the cause.

If you have already been diagnosed with carpal tunnel syndrome and are concerned about ATTR, talk to your doctor about seeing a cardiologist or neurologist. ATTR can be difficult to diagnose. These specialists have expertise in diagnosing ATTR since it most often affects the heart and nerves.

It’s especially important to talk to a doctor if you have factors that put you at higher risk for ATTR. These include:

• Carpal tunnel in both your wrists
• Other unexplained nerve problems
• Spinal stenosis or frequent tendon injuries
• Family history of ATTR, heart failure early in life, or unexplained nerve problems
• Lack of repetitive movements that can cause carpal tunnel (like typing)

You should also see a doctor if you have symptoms that may indicate a heart problem, whether or not you have carpal tunnel. Examples are:

• Unexplained shortness of breath
• Heart palpitations
• Leg swelling
• Fatigue

Serious and sudden problems, such as severe chest pain, should receive immediate medical attention.