The importance of inspection in clinical cardiology: Frank's sign

Abstract

Frank's sign (FS) is a diagonal earlobe crease running from the tragus to the edge of the auricle at an angle of approximately 45°. Sanders T. Frank first described it in 1973 as a dermatological finding predictive of coronary artery disease. 1 Researchers have described FS in Italian Renaissance Art 2 and in Greco-Roman sculptures. 3 FS has been associated with the presence and severity of cardiovascular disease. 4,5 The sensitivity and specificity of FS in predicting coronary artery disease were 80.65% and 44.15% in COPD patients, respectively. 6 In this case, we present a patient with FS and multiple risk factors for cardiovascular disease presenting with myocardial infarction. | CASE PRESENTATIONA 71-year-old male patient presented to the emergency department complaining of epigastric pain radiating in the left shoulder accompanied with diaphoresis. The medical history included type 2 diabetes mellitus, hypertension, dyslipidemia, paroxysmal atrial fibrillation/atrial flutter, a smoking history of >30 pack-years, and prior myocardial infarction requiring percutaneous coronary intervention in the left anterior descending artery 9 years ago. The medical treatment included dabigatran 150 mg bid, pravastatin/fenofibrate 40/160 mg od, metformin 1000 mg bid, furosemide 40 mg od, allopurinol 100 mg od, and ramipril 2,5 mg od. The clinical examination was unremarkable. His initial electrocardiogram showed sinus rhythm

Clinical Value of the Diagonal Earlobe Crease in Patients with Chest Pain for Diagnosing Coronary Heart Disease

“…35 Frank's sign has previously been reported. 36 A Japanese study of men with Frank's sign and metabolic syndrome found that the leukocyte telomere length in subjects with DECL were shortened. 37 In our study, DELC was significantly and positively associated with CHD (P=0.006), and it may increase the prevalence of CHD.…”