Learning Cardiology

Frank sign-  Diagonal ear lobe crease (DELC) sign The Frank's sign is a diagonal crease in the earlobe that runs backward from the tragus at a 45-degree angle across the lobule to the rear edge of the auricle and may be a predictor of coronary artery disease. Frank sign is indicative of coronary artery disease (CAD). Frank's sign is thought to indicate premature aging and loss of dermal and vascular elastic fibers.  Although it has limited sensitivity, the sign is more useful diagnostically in persons younger than 60 years of age than in older persons. Sensitivity of 43% and specificity of 70% Pathophysiology: Microvascular disease of ear lobe which is end artery territory Grading system for severity of CAD                • Unilateral incomplete – least severe                • Unilateral complete                • Bilateral complete – most severe                Other classifications systems exist, but without the association with