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Cureus. 2019 Mar 11;11(3):e4219. doi: 10.7759/cureus.4219.

Diagonal Earlobe Crease, a Marker of Coronary Artery Disease: A Case Report on Frank's Sign.

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Cardiology, The Brooklyn Hospital Center - Mount Sinai Heart, Brooklyn, USA.


There are various physical signs that can be used as a reliable tool to diagnose the subclinical stages of atherosclerosis, including corneal arcus, xanthelasma, and diagonal earlobe crease (DELC) or "Frank's sign". Bilateral diagonal earlobe crease has been positively correlated with coronary artery disease (CAD) and peripheral vascular disease (PVD). The presence of DELC has been identified as an independent variable for CAD. The exact etiology is unknown and the association between the presence of DELC and coronary artery disease (CAD) still remains controversial. We report a case of a patient with bilateral DELC who was found to have remarkable non-occlusive CAD on diagnostic coronary angiography.


case report; coronary atery disease; diagonal earlobe crease; frank sign; peripheral vascular disease; physical examination

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