Frank’s Sign, also known as the diagonal earlobe crease (DELC), is a diagonal crease running at an approximately 45-degree angle across the earlobe. First identified by Dr. Sanders T. Frank in patients with angina, it was initially linked to coronary artery disease. Subsequent research has connected it to broader circulatory issues, including peripheral vascular and cerebrovascular disease, suggesting it may be an external marker of systemic poor blood circulation and vascular aging, rather than just a natural sign of growing older.

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The sign is frequently observed in cardiology patients, especially those with a history of procedures like coronary artery bypass surgery. However, its presence in seemingly healthy individuals can also indicate an increased risk of underlying vascular disease. Notably, the crease is not associated with body weight, as it can appear in both slim and overweight persons.

The precise mechanism behind Frank’s Sign is not fully understood. One theory suggests it may be caused by microvascular disease in the earlobe, an area supplied by terminal arteries. Other research points to a connection with broader vascular aging processes, such as atherosclerosis and shortened telomeres observed in patients with conditions like metabolic syndrome.

The severity of the sign can be categorized to help estimate cardiovascular risk. An incomplete crease on one earlobe is considered the least severe, a complete crease on one lobe is more significant, and the most severe presentation is a complete crease on both earlobes.

In conclusion, while Frank’s Sign alone is not a definitive diagnosis of heart disease, it serves as a valuable early warning indicator. It is particularly useful for raising suspicion of coronary artery disease and prompting further cardiovascular screening, especially in individuals under 60 years of age. If this sign is noticed, it is advisable to seek a medical check-up.