What your ears can tell you about cardiovascular disease

Cardiovascular disease (CVD) is a group of disorders of the heart and blood vessels including coronary heart disease, heart attack, arrhythmia, cerebrovascular disease, peripheral arterial disease, deep vein thrombosis, and more.  Symptoms of a possible CVD event are pain or discomfort in the center of the chest and/or in the arms, left shoulder, elbows, jaw, or back.  Other common symptoms of CVD are sudden weakness of the face, arm, or leg most often on one side of the body, numbness of the face, arm, or leg, especially on one side of the body, confusion, difficulty speaking or understanding speech, difficulty seeing with one or both eyes, difficulty walking, dizziness, low energy, loss of balance or coordination, severe headache with no known cause, and fainting or unconsciousness.  When it comes to CVD many of us are familiar with the typical risk assessments that raise your risk of CVD such as past or current smoker, high blood pressure, low HDL levels on blood work, family history of CVD, obesity, birth control medications, higher stress levels, inflammation, alcohol consumption, inactivity, elevated CRP, elevated lipo(a), elevated homocystine, elevated fibrinogen, high fasting insulin, and diabetes.  But, almost no one knows about diagonal earlobe creases (DELC) or Frank’s sign; Frank’s sign is named after Sanders T. Frank, M.D., who discovered it in the 1970s while examining a patient with heart disease. 

The stats on CVD

Johns Hopkins University reports some interesting stats on CVD.  CVD causes about 2,200 deaths per day averaging one death every 40 seconds, 1 out of every three deaths results from CVD, CVD costs about $315 billion per year and is increasing, CVD causes more deaths than cancer, chronic lower respiratory diseases, and accidents combined.  The CDC stats show that the number of adults diagnosed with heart disease is 28.4 million which accounts for 11.7% of the population.  CVD accounts for 18.6 million doctor office visits per year, 1.9 million outpatient hospital visits per year, and roughly 1 million ER visits per year.  There are 614, 348 deaths per year caused by CVD and CVD is ranked the #1 cause of death.

What exactly is the Frank’s Sign?

Identifying Frank’s Sign is quite simple really.  Look at your ears and focus on the lobe part.  If you see a diagonal crease or wrinkle you have a Frank Sign or DELC; specifically the crease starts higher, from the tragus, and extends down and outward to the rear edge of the auricle.  There is some controversy about this sign, but in my years of experience it is a pretty good indication someone might have some type of CVD and the need for further evaluation and testing.  There are many studies looking into this sign and its relationship to CVD, but no one quite understands how or why these creases form.  One study found an increased risk of CVD cause of death with Frank’s sign.  They found that Frank’s sign increased the risk of death 1.5 times in men and 1.7 times in non-diabetic women.1 Another study discussed Frank’s sign as being associated with higher risk of major adverse cardiac events in patients with known CAD, a marker of generalized atherosclerotic disease, carotid-intima media thickness, subclinical atherosclerosis in people without CVD, and ischemic stroke.2 While another study showed that these DELC’s proved to be an indication of CVD even without the common other CVD risk factors, in other words it is a good stand alone indicator of CVD by and in of itself.3

In summary, CVD is one of the number one killers in our country and many of the risk factors can be prevented through healthy lifestyle.  The World Health Organization states “Most cardiovascular diseases can be prevented by addressing behavioral risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol”.  Know the risk factors that you have personally.  Have a healthcare professional guide you on your personal risks and how to minimize these risk factors through lifestyle modifications, clean eating, stress reduction, sleep and exercise.  Be proactive on this often times the first sign of a heart attack is a heart attack.  Until next time where we will continue our journey of healthy living and clean eating together.


1.Br Heart J. 1989 Apr; 61(4): 361-364 Diagonal earlobe creases and fatal cardiovascular disease: a necropsy study.

2. Circulation. 2014;130:92-93. Bilateral Earlobe Creases and Coronary Artery Disease.

3. Wang Y, Mao L, Jia E, et al. Relationship between diagonal earlobe creases and coronary artery disease as determined via angiography. BMJ Open 2016;6:e008558.

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