A straightforward thumb test has emerged as a potential tool for detecting a hidden aortic aneurysm, which can be life-threatening if left untreated, as revealed by recent research. This innovative screening method, devised by experts at Yale New Haven Hospital’s Aortic Institute, entails positioning your hand as if signaling to halt and then extending your thumb across your palm. If your thumb surpasses the edge of your palm, it may suggest the presence of an aneurysm—an abnormal expansion in the primary blood vessel that transports blood from the heart to the body.
This flexibility in thumb movement indicates the potential for oversized long bones and loose joints, which could signal connective tissue disorders that impact the whole body, including the aorta. The research, featuring 305 heart surgery patients, was published in the American Journal of Cardiology and focused on those treated for conditions such as ascending aneurysms, valve repairs, and coronary bypass grafting. In 2018 alone, aortic aneurysms accounted for 992 fatalities.
The findings indicated that while the majority of individuals with aneurysms do not exhibit the positive thumb-palm sign, a significant number of those who do are at a heightened risk of having an ascending aneurysm. Nevertheless, researchers warn that not everyone yielding a positive result has an aneurysm, as these may develop slowly over several years. Thus, a positive test result should not incite undue alarm.
Dr. John A. Elefteriades, a Yale professor and director emeritus of the Aortic Institute, highlighted the importance of raising awareness about this test, stating it could assist in recognizing individuals who unknowingly harbor silent aneurysms, ultimately saving lives. He and his team have integrated the thumb-palm assessment into medical training programs and have conducted tests on individuals at risk for aneurysm development.
Early detection of aortic aneurysms remains a complex challenge, as noted by Elefteriades. The critical concern is identifying those at risk before an aneurysm ruptures. In 2018, nearly 992 deaths were attributed to these conditions, with about half affecting men. Smoking has been linked to approximately 75% of abdominal aortic aneurysms, prompting the US Preventive Services Task Force to recommend that men aged 65 to 75 with a history of smoking undergo ultrasound screening for abdominal aortic aneurysms, even if they report no symptoms.
An abdominal aortic aneurysm is diagnosed when the diameter of the abdominal aorta reaches 3 centimeters or more. Normal thoracic aorta diameters can vary based on age, sex, and the specific section being assessed. During physical examinations, doctors may detect an aortic aneurysm by palpating the abdomen, listening for audible heart murmurs, examining blood flow in the extremities, and looking for indicative signs of conditions like Marfan and Ehlers-Danlos syndromes.
Aortic aneurysm screenings are commonly performed using ultrasound technology, allowing for the assessment of whether the aorta exceeds typical size parameters. Should there be a suspicion of an aneurysm, additional imaging tests, such as CT scans or MRIs, may be recommended to provide further insights into its shape and location. Echocardiography can offer information about the size of an aortic aneurysm and the thoracic aorta near the heart, while MRI is useful for elucidating the aneurysm’s configuration, dimensions, and placement.
Specific demographics are advised to undergo screening for thoracic aortic aneurysms, including those with Marfan, Loeys-Dietz, Ehlers-Danlos, or Turner syndromes, as well as first-degree relatives of individuals diagnosed with thoracic aortic aneurysms or aneurysms related to bicuspid valves. Additionally, screening for abdominal aortic aneurysms is recommended for men aged 65 to 75 with prior smoking histories or familial predispositions to the condition, along with older adults who present other risk factors.
