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

Donate: https://emergencymedicalminute.org/donate/

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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 Aug 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 Juli 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 ...

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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 Juli 20253min

Episode 965: Oxygen Administration in Trauma Patients

Episode 965: Oxygen Administration in Trauma Patients

Contributor: Aaron Lessen, MD Educational Pearls: Many trauma patients are placed on oxygen via non-rebreather A large, multicenter, controlled trial evaluated the outcomes of oxygen administration i...

14 Juli 20252min

Episode 964: Ketamine & Midazolam for Prehospital Seizure Management

Episode 964: Ketamine & Midazolam for Prehospital Seizure Management

Contributor: Aaron Lessen, MD Educational Pearls: Prehospital seizures are typically managed with intramuscular midazolam (Versed) Seizures theoretically involve the NMDA pathway, and ketamine is a p...

7 Juli 20254min

Episode 963: Antihypertensives and Emergency Room Considerations

Episode 963: Antihypertensives and Emergency Room Considerations

Contributor: Alec Coston, MD Educational Pearls: For patients presenting to the emergency room with hypertension, clinicians should determine if it is isolated and uncomplicated, or involves comorbidi...

30 Juni 20254min

Episode 962: HEART Score

Episode 962: HEART Score

Contributor: Taylor Lynch, MD Educational Pearls: How do we risk-stratify chest-pain patients? One option is the HEART score This score predicts a patient's 6-week risk of a major adverse cardiac ev...

23 Juni 20254min

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