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 942: Acute Mountain Sickness and High Altitude Cerebral Edema

Episode 942: Acute Mountain Sickness and High Altitude Cerebral Edema

Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Acute mountain sickness (AMS) is the term given to what is otherwise colloquially known as altitude sickness High altitude cerebral ed...

3 Helmi 20253min

Episode 941: Rehydration in Pediatric Gastroenteritis

Episode 941: Rehydration in Pediatric Gastroenteritis

Contributor: Meghan Hurley, MD Educational Pearls: Gastroenteritis clinical diagnoses: Diarrhea with or without vomiting and fever Vomiting in the absence of diarrhea has a large list of diffe...

27 Tammi 20253min

Episode 940: Laceration Repair Methods

Episode 940: Laceration Repair Methods

Contributor: Aaron Lessen, MD Educational Pearls: If a patient sustains a cut, the provider has several options on how to close the wound. If they choose to suture the wound closed, it involves need...

20 Tammi 20252min

Episode 939: Serotonin Syndrome

Episode 939: Serotonin Syndrome

Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Serotonin syndrome occurs most commonly due to the combination of monoamine oxidase inhibition with concomitant serotonergic medications...

13 Tammi 20253min

Episode 938: AHA Policy on Management of Elevated Blood Pressure (BP) in the Acute Care Setting

Episode 938: AHA Policy on Management of Elevated Blood Pressure (BP) in the Acute Care Setting

Contributor: Aaron Lessen, MD Educational Pearls: Many patients present to the ED with elevated BP Many are referred from outpatient surgery centers or present after an elevated measurement at ho...

6 Tammi 20252min

Episode 937: Pneumomediastinum

Episode 937: Pneumomediastinum

Contributor: Megan Hurley MD Educational Pearls: What is the mediastinum? The thoracic cavity is separated into different compartments by membranes The lungs exist in their own pleural cavities, a...

30 Joulu 20245min

Episode 936: Etomidate vs. Ketamine for Rapid Sequence Intubation

Episode 936: Etomidate vs. Ketamine for Rapid Sequence Intubation

Contributor: Ricky Dhaliwal MD Educational Pearls: Etomidate was previously the drug of choice for rapid sequence intubation (RSI) However, it carries a risk of adrenal insufficiency as an adver...

23 Joulu 20244min

Episode 935: Pregnancy Extremis - TOLDD

Episode 935: Pregnancy Extremis - TOLDD

Contributor: Aaron Lessen MD Educational Pearls: Pregnant patients at high risk of cardiac arrest, in cardiac arrest, or in extremis require special care A useful mnemonic to recall the appropriat...

16 Joulu 20243min

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