Connection Between Transthyretin Cardiomyopathy and Carpal Tunnel Syndrome

Living with carpal tunnel syndrome can be a warning sign for a more serious heart condition called transthyretin amyloidosis cardiomyopathy (ATTR-CM). While scary, this connection might give you a heads up about potential future heart problems.

Cardiologist Wai Hong Wilson Tang, MD, explains that having carpal tunnel syndrome in both wrists can indicate an increased risk for ATTR-CM. So, if you've been dealing with persistent wrist pain and numbness, it's worth paying attention.

The Connection Between Carpal Tunnel and ATTR-CM

Carpal tunnel syndrome doesn't directly cause ATTR-CM, but it can be a result of a condition called amyloidosis. Amyloidosis affects various organs, including the heart, and could be the underlying cause for both carpal tunnel syndrome and ATTR-CM.

Amyloidosis and Proteins

Proteins are vital building blocks in your body, with transthyretin being one of them. These proteins are produced in your liver and carry vitamins, hormones, and more throughout your body. But sometimes, transthyretin proteins fail to fold correctly, leading to the formation of crystal-like deposits known as "amyloid."

These improperly folded proteins, or jigsaw puzzle pieces that don't quite fit, travel through your body. Over time, they fall apart and get deposited as TTR fibrils in tissue that doesn't regenerate easily, such as the heart and nerves. This buildup can lead to amyloidosis.

ATTR-CM and Your Heart

Amyloidosis can appear in various places in your body, but TTR fibrils tend to collect in heart tissue, making it stiff and weak. In some cases, this can lead to heart failure.

The Link to Carpal Tunnel

Carpal tunnel syndrome happens when something irritates the nerves running through your wrist, causing compression. Sometimes, this compression is due to a buildup of TTR fibrils. This suggests that if amyloidosis caused your carpal tunnel syndrome, you might develop ATTR-CM in the future.

"It's a progressive deterioration," Dr. Tang explains. "The deposits cause symptoms first in small spaces. The heart is much bigger, so it takes longer for amyloid deposits to cause problems."

If amyloidosis is causing your carpal tunnel, you're likely to have issues with both wrists, not just one. Additionally, you may experience symptoms in other areas of your body, such as your legs, kidneys, or spinal cord.

While carpal tunnel syndrome is common and often caused by repetitive hand motions like typing or knitting, researchers have discovered a connection between this condition and ATTR amyloidosis. However, the extent to which amyloidosis contributes to carpal tunnel syndrome is still unknown.

Diagnosing and Preventing ATTR-CM

ATTR-CM typically emerges in individuals aged 60 or older, though exceptions do occur. In some cases, the condition may be linked to a genetic variation that increases the risk of developing ATTR-CM by up to 40%. If you've been diagnosed with carpal tunnel syndrome, particularly in both wrists, it's essential to consult with a cardiologist to assess your risk for ATTR-CM, especially if you're over 60.

While there's no known prevention for ATTR-CM, hope lies in clinical trials to test possible treatments that could prevent amyloid fibrils from depositing into organs. ATTR-CM can be managed and treated when detected early, so it's crucial to be aware of symptoms such as shortness of breath, fatigue, swift weight gain, irregular heart rhythms, and confusion. If you experience any of these symptoms, reach out to a healthcare provider for further evaluation.

In conclusion, while carpal tunnel syndrome might seem unrelated to heart health, it could serve as a crucial early warning sign for ATTR-CM. By paying attention to persistent wrist pain and seeking medical advice, you can take a proactive approach to your health and potentially prevent future complications.

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