Episode 960: Frank's Sign - A Marker for Coronary Artery Disease

Episode 960: Frank's Sign - A Marker for Coronary Artery Disease

Contributor: Travis Barlock MD
Educational Pearls

  • Frank's sign is a curious physical exam finding first described in the literature in 1973
    • Bilateral earlobe creases are recognized as a marker of coronary artery disease and cerebrovascular disease
  • Some studies have found an increase in all-cause mortality in patients with bilateral diagonal earlobe creases
  • The pathophysiology is still not fully understood
    • One 2020 study found histopathological changes associated with diagonal earlobe creases, potentially linking them via a model of hypoxia/reoxygenation

References

  1. Elliott WJ, Karrison T. Increased all-cause and cardiac morbidity and mortality associated with the diagonal earlobe crease: a prospective cohort study. Am J Med. 1991;91(3):247-254. doi:10.1016/0002-9343(91)90123-f
  2. Nazzal S, Hijazi B, Khalila L, Blum A. Diagonal Earlobe Crease (Frank's Sign): A Predictor of Cerebral Vascular Events. Am J Med. 2017;130(11):1324.e1-1324.e5. doi:10.1016/j.amjmed.2017.03.059
  3. Stoyanov GS, Dzhenkov D, Petkova L, Sapundzhiev N, Georgiev S. The Histological Basis of Frank's Sign. Head Neck Pathol. 2021;15(2):402-407. doi:10.1007/s12105-020-01205-4

Summarized & Edited by Jorge Chalit, OMS4

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Episode 972: Hepatic Encephalopathy

Episode 972: Hepatic Encephalopathy

Contributor: Alec Coston, MD Educational Pearls: Hepatic encephalopathy (HE) is defined as a disruption in brain function that results from impaired liver function or portosystemic shunting. Manifes...

3 Syys 20253min

Episode 971: Calcium Pretreatment for Diltiazem in AFib with RVR

Episode 971: Calcium Pretreatment for Diltiazem in AFib with RVR

Contributor: Taylor Lynch, MD Educational Pearls: What is atrial fibrillation with rapid ventricular response (AFib with RVR) and how does it differ from atrial fibrillation (AFib)? AFib is an abnorm...

25 Elo 20252min

Episode 970: Fever Management

Episode 970: Fever Management

Contributor: Aaron Lessen, MD Educational Pearls: Recorded March 2025 What is the best treatment for a fever? Tylenol? Ibuprofen? Combined? Alternating the two? The journal Pediatrics aimed to answer...

22 Elo 20252min

Episode 969: Shoulder Reduction

Episode 969: Shoulder Reduction

Contributor: Aaron Lessen, MD Educational Pearls: There are many techniques for reducing a shoulder dislocation A recent study discussed a new variation of closed reduction technique: wrist-clamping ...

11 Elo 20252min

Episode 968: Heavy Metals

Episode 968: Heavy Metals

Contributor: Megan Hurley MD Educational Pearls: Acute toxicity of heavy metals: Gastrointestinal upset is the most common presentation Chronic toxicity of heavy metals: Symptoms depend on the meta...

4 Elo 20252min

Episode 967: Dilutional Hyponatremia

Episode 967: Dilutional Hyponatremia

Contributor: Taylor Lynch, MD Educational Pearls: Dilutional Hyponatremia: Occurs when there is an excess of free water relative to sodium in the body. Causes a falsely low sodium concentration witho...

28 Heinä 20252min

EMSAC 2024

EMSAC 2024

Contributors: Col. (Dr.) Stacy Shackelford Dr. Sean Keenan Paramedic Alan Moreland Dr. Chris Tems Kara Napolitano From military-inspired trauma protocols to behavioral health alternatives and cardiac ...

26 Heinä 202511min

Episode 966: Acetaminophen Toxicity

Episode 966: Acetaminophen Toxicity

Contributor: Jorge Chalit-Hernandez, OMS4 Educational Pearls: What is the toxic dose of acetaminophen? 7.5 grams, in an adult. The safe daily limit is 4 grams in an adult with a normally functioning...

21 Heinä 20253min

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