Title: Clinical Profile of Coronary Artery Disease Patients with Special Reference to Ear Lobe Crease and Ear Canal Hair
Authors: Dr S.V. Birajdar, Dr Akshay V. Bharati, Dr S.S. Chavan, Dr S.A. Chaudhari
DOI: https://dx.doi.org/10.18535/jmscr/v8i3.59
Abstract
Background: The burden of coronary artery disease (CAD) is on the rise globally & we need simple and reliable physical signs to identify high risk individuals. There are very few studies related to prevalence of Ear lobe crease (ELC) & Ear canal hair (ECH) and its association with CAD in Indian population.
Aim: To find out incidence of ear lobe crease and ear canal hair in patients of myocardial infarction & their correlation with other known risk factor of myocardial infarction.
Materials & Methods: It was an observational, cross-sectional study conducted in a rural tertiary care center consisting of two groups, study group consisting of 100 cases of myocardial infarction and control group consisting of 200 patients having disease other than coronary artery disease& were studied for the presence of Ear lobe crease and ear canal hair and relation with other risk factors.
Results: The study group was divided into two groups, group A with known risk factors (78%) & group B with without known risk factors (22%). In study group A,43.58% had both ear lobe crease and ear canal hair while 29.5% had isolated ear lobe crease. In group B,31.8% had both ear lobe crease and ear canal hair and isolated ear lobe crease.74% of study participants and 16% of control group had ear lobe crease while 35% in study group and 6% of control group had ear canal hair. Incidence of death was more in group B (31.18%) than in group A (14.10%).
Conclusion: Incidence of complications and death was more in a group with known risk factors absent when compared with the group in which known risk factors were present, thus it can be concluded that ,ear lobe crease & ear canal hair is not only an independent risk factor for coronary artery disease but also a bad prognostic indicator.
Keywords: Coronary artery disease, Ear lobe crease, Ear canal hair.
References
- Dwivedi s, Jhanab R. Cutaneous markers of coronary artery disease. World J Cardio12010;2(9):262-9
- Rahman K. Studies on free radicals, anti-oxidants, and co-factors. Clin Interv Aging 2007; 2(2):219-36
- Gupta R. Recent trends in coronary heart disease epidemiology in India. Indian Heart J 2008; 60(2 SupplB):B4-18.
- Begom R, Singh RB. Prevalence of coronary artery disease and risk factors in urban population of south and north India. Acta Cardiologica 1995; 50(3):227-40.
- Rodríguez‑López C, Garlito‑Díaz H, Madroñero‑Mariscal R, Sánchez‑Cervilla PJ, Graciani A, López‑Sendón JL, et al. Earlobe crease shapes and cardiovascular events. Am J Cardiol 2015;116:286‑93.
- Frank ST. Aural sign of coronary‑artery disease. N Engl J Med 1973;289:327‑8.
- Nyboe J, Jensen G, Appleyard M, Schnohr P. Risk factors for acutemyocardial infarction in Copenhagen. I: Hereditary, educational andsocioeconomic factors. Copenhagen City heart study. Eur Heart J1989;10:910‑6.
- Davis TM, Balme M, Jackson D, Stuccio G, Bruce DG. The diagonal earlobe crease (Frank’s sign) is not associated with coronary artery diseaseor retinopathy in type 2 diabetes: The Fremantle diabetes study. Aust NZ J Med 2000;30:573‑7.
- Lichstein E, Chadda KD, Naik D, Gupta PK. Diagonal ear‑lobe crease: Prevalence and implications as a coronary risk factor. N Engl J Med 1974;290:615‑6.
- Chen WC, Zhao TM, Xue W, Dong CL: Ear lobe crease, high serum cholesterol and human leukocyte antigen, risk factors in coronary artery disease. Chin Med J (Engl) 1982;95:839–842.
- Kaukola S: The diagonal ear-lobe crease, a physical sign associated with coronary heart disease. AElliot WJ: Earlobe crease and coronary artery disease: 1,000 patients and review of the literature. Am J Med 1983;75:1024–1032.
- Chen WC, Zhao TM, Xue W, Dong CL: Ear lobe crease, high serum cholesterol and human leukocyte antigen, risk factors in coronary artery disease. Chin Med J (Engl) 1982;95:839–842.
- Pasternac A, Sami M: Predictive value of the ear crease sign in coronary artery disease. Can Med Assoc J 1982;126:645–649.
- Verma SK, Khamesra R, Mehta LK, Bordia A: Ear-lobe crease and ear-canal hair as predictors of coronary artery disease in Indian population. Indian Heart J 1989;41:86–91.
- Shoenfeld Y, Mor R, Weinberger A, Avidor I, Pinkhas J: Diagonal earlobe crease and coronary risk factors. J Am Geriatr Soc 1980;27: 184–187.
- Montazeri M, Montazeri M, Rashidi N, Montazeri M, Montazeri M. Diagonal earlobe crease and coronary artery disease in Iranian population: A marker for evaluating coronary risk. Indian J Otol [Internet]. 2014 Oct 1 [cited 2020 Feb 22];20(4):208–10. Available from: http://www.indianjotol.org/text.asp?2014/20/4/208/146941
- Bawaskar H, Bawaskar P, Bawaskar P. Diagonal ear lobe crease: A premonitory diagnostic sign of impeding ischemic heart disease. J Fam Med Prim Care [Internet]. 2018 [cited 2020 Feb 22];7(6):1361. Available from: http://www.jfmpc.com/text.asp?2018/7/6/1361/246471
- Study To Evaluate The Freqency Of Diagonal Earlobe Crease As A Marker Of Coronary Artery Disease At Rims Ranchi., IJSR - International Journal of Scientific Research (IJSR), IJSR | World Wide Journals [Internet]. [cited 2020 Feb 22]
- Wu X-L, Yang D-Y, Zhao Y-S, Chai W-H, Jin M-L. Diagonal earlobe crease and coronary artery disease in a Chinese population. BMC Cardiovasc Disord. 2014;14:43.