CRPS and heart problems

Not many years ago, significant doubt remained about whether CRPS could spread beyond the extremities. Indeed, the condition remains very far from understood. But it’s now clear that it can spread to – or certainly affect – any part of the body. Here, we consider CRPS and heart problems.

CRPS and heart problems

Many people with CRPS experience intermittent chest pain, which is commonly mistaken for indigestion or, worse, heart problems. However, studies have shown that this is more often the result of neuropathic pain emanating from a network of nerve fibres called the brachial plexus. These nerves supply motor and sensory signals from the skin and muscles in the upper limbs.

A major study involving around 2,500 participants at Drexel University College of Medicine in Philadelphia considered the incidence of heart problems in people suffering from CRPS. Participants were at least two years from diagnosis, with the average condition duration being 6½ years. The study results supported earlier, smaller-scale studies concluding that people with CRPS have:

• an increased heart rate, and
• decreased heart rate variability (HRV).

Worryingly, a decreased HRV is associated with a higher risk of death after suffering a heart attack. Researchers also found that around 10% of participants described occasional light-headedness or even passing out, likely due to a fall in blood pressure.

The study concluded that cardiac issues in those with CRPS were likely the result of a general imbalance in the autonomic nervous system.

How does CRPS affect the heart?

The exact mechanism of how CRPS affects the heart is not well understood. There are several theories, but a common denominator is the nerves supplying the heart muscle, fed from the cardiac plexus, part of the sympathetic nervous system (in turn, part of the autonomic nervous system).

Symptoms of CRPS are likely the result of dysfunctional sympathetic nerves sending inappropriate signals to the brain. If those dysfunctional nerves cause symptoms in your foot or hand, might they also trigger symptoms in your heart and other organs?

Should cardiac risk be a consideration in a CRPS compensation claim?

Put simply, yes. At the very least, the available research means your pain medicine or rheumatology expert should comment on cardiac risk factors. Whether it’s necessary to go the extra mile and obtain a report from a cardiologist depends on the nature and extent of any current cardiac symptoms and your medical history. These are issues that your solicitor will discuss with you.