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 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 Jan 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 Dec 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 Dec 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 Dec 20243min

Episode 934: Subendocardial Ischemia

Episode 934: Subendocardial Ischemia

Contributor: Travis Barlock MD Educational Pearls: What is the ST segment? The ST segment on an ECG represents the interval between the end of ventricular depolarization (QRS) and the beginning of v...

9 Dec 20243min

Episode 933: Benign Convulsions with Gastroenteritis

Episode 933: Benign Convulsions with Gastroenteritis

Contributor: Alec Coston MD Educational Pearls: Causes of seizures in a fairly well-appearing child with diarrhea: Electrolyte abnormalities: hypocalcemia, hyponatremia Also hyperkalemia which...

2 Dec 20243min

Episode 932: Induction Agent Hypotension

Episode 932: Induction Agent Hypotension

Contributor: Aaron Lessen MD Educational Pearls: Induction agent selection during rapid sequence intubation involves accounting for hemodynamic stability in the post-intubation setting Many emerge...

25 Nov 20242min

Episode 931: Naloxone in Cardiac Arrest

Episode 931: Naloxone in Cardiac Arrest

Contributor: Aaron Lessen MD Educational Pearls: Can opioids cause cardiac arrest? Opioids can cause respiratory suppression and the subsequent low oxygen levels can lead to arrhythmias and eventual...

18 Nov 20243min

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