How Accurate Is Thumb-Palm Test in Identifying Hidden Aortic Aneurysm? Yale Researchers Explain This Simple Exercise

In 2021, researchers from Yale University published a study in the American Journal of Cardiology about a simple self-administered test utilizing the thumb and palm that can potentially inform individuals of their risk for any hidden aortic aneurysm, helping to identify thousands of cases annually.

Aortic aneurysm is responsible for approximately 10,000 deaths each year as per the Centers for Disease Control and Prevention (CDC), ranking as the 13th leading cause of mortality in the United States. Detecting aneurysms early enables the implementation of precautionary measures such as exercise limitations, radiographic surveillance, or surgical intervention to ensure patient safety.

What Is the Thumb-Palm Test?

Dr. John A. Elefteriades, a prominent Yale surgeon and author of a new study, said in the news release that the major challenge in dealing with aortic aneurysms is identifying individuals at risk before the aneurysm ruptures.

Elefteriades and his colleagues have been using a thumb-palm test for the past two decades to evaluate patients who may be susceptible to aneurysms, but the accuracy of the test had not been assessed in a clinical setting until now.

The proposed self-conducted test, developed by experts from the Aortic Institute at Yale New Haven Hospital, involves a simple hand gesture resembling a "stop" sign. The individual is instructed to bend their thumb as much as they can across their palm.

If the thumb extends beyond the edge of the palm, it could indicate the presence of a hidden aneurysm. According to the researchers, the ability to extend the thumb to such an extent suggests that the patient may have elongated bones and loose joints, which could be indicative of connective tissue disease affecting various parts of the body, including the aorta.

The findings were reported in the study, which analyzed data from 305 patients who were undergoing heart surgery for various conditions such as ascending aneurysm, valve repair, and coronary artery bypass grafting.

Is the Thumb-Palm Test Accurate?

Researchers clarify that not everyone who tests positive for the thumb-palm sign is an aneurysm carrier, New York Post reported. Aneurysms typically progress slowly over several decades, and a positive test should not cause immediate alarm. Researchers found that while most aneurysm patients did not exhibit a positive thumb-palm sign, those who did had a higher likelihood of harboring an aneurysm.

Based on these findings, Elefteriades and his team recommend incorporating the thumb-palm test into routine physical examinations, particularly for individuals with a family history of aortic aneurysm. They believe that raising awareness of this test could help identify individuals with silent aneurysms, potentially saving lives.

Dr. Elefteriades and his colleagues have been teaching the thumb-palm test in medical lectures and using it on individuals who may be at risk of having an aneurysm. However, until now, the team noted that the accuracy of the test had not been assessed in a clinical setting.

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