Simple thumb test can help indicate hidden aortic aneurysm

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A simple thumb test can help indicate whether a person is harboring a hidden aortic aneurysm — which can prove fatal if left undetected and untreated, new research reveals. 

The self-conducted test, proposed by experts affiliated with the Aortic Institute at Yale New Haven Hospital, requires holding up one hand as if signaling someone to stop. 

Then, the person should flex their thumb as far as possible across the palm. If the thumb crosses beyond the far edge of the palm, the patient may be hiding a hidden aneurysm — an abnormal bulge that occurs in the wall of the major blood vessel that carries blood from the heart throughout the body.

Being able to stretch the thumb in that way is an indication that a patient’s long bones are excessive and their joints are lax — possible signs of connective tissue disease throughout the body, including the aorta, the researchers said.

The findings, drawing on results from 305 patients undergoing heart surgery, were published last week in the American Journal of Cardiology.

The patients were in treatment for disorders including ascending aneurysm, valve repair and coronary artery bypass grafting.

Thumb to palm test
Aortic aneurysms were the cause of 9,923 deaths in 2018.

The study found that the majority of aneurysm patients do not manifest a positive thumb-palm sign — but that patients who do have a positive sign have “a very high likelihood of harboring an ascending aneurysm.” 

However, the researchers also stressed that it also doesn’t mean everyone who tests positive is an aneurysm carrier — and that aneurysms take decades to progress to the point of rupture, so a positive test isn’t a cause for panic.

A negative thumb test does not exclude an aneurysm, either. 

But “spreading knowledge of this test may well identify silent aneurysm carriers and save lives,” said Dr. John A. Elefteriades, the William W.L. Glenn Professor of Surgery at Yale and emeritus director of the Aortic Institute at Yale New Haven Hospital.

Elefteriades said he and his colleagues have included the thumb-palm test in lectures to medical students and used the test on those who might be at risk of carrying an aneurysm. 

But the test’s accuracy had not previously been evaluated in a clinical setting, the researchers said.

Aortic aneurysms are hard to detect in advance, according to Elefteriades. 

“The biggest problem in aneurysm disease is recognizing affected individuals within the general population before the aneurysm ruptures,” the doctor said. 

Aortic aneurysms were the cause of 9,923 deaths in 2018, according to the CDC.

That year, about 58 percent of deaths due to aortic aneurysm or aortic dissection were among men.

A history of smoking accounts for about 75 percent of all abdominal aortic aneurysms — and the U.S. Preventive Services Task Force recommends that men between 65 and 75 years old who have ever smoked should get an ultrasound screening for abdominal aortic aneurysms, even without symptoms.

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