Frank's Sign

Frank's Sign - Signs of underlying disease that increases risk for heart attack and stroke. 
by Nurse Eric

This article is intended for educational purposes only.


Since starting my career as a nurse in 2012 I've been intrigued by the bedside physical assessment signs that point to inward disease because I believe that a nurse who can identify problems before they become deadly can save lives. 

Here's a link to a video I made telling the story of how I learned about Frank's Sign.

Take a look at this comment I received on this video about Frank's Sign. I think it's incredible that someone followed through to get a CT scan because of what they saw in their earlobes. Look at what it said. It's good he followed through.

Frank's sign is one of those outward signs that can point to some big problems. Think of it like the canary in the coal mine. Poor canaries! 

Coronary Artery Disease and Risk for Stroke are both associated with the Frank's Sign (Auricular Earlobe Crease). 

(Stroke) In this article, I will explore the literature, anatomy, and physiology behind the diagonal earlobe crease and it's known correlation with specific diseases. 

So why does the earlobe crease occur anyway? I wondered that myself so I looked up the anatomy of the ear and found the arteries give us a clue. The earlobe itself is actually supplied by two arteries one from the top and one from the bottom. Look at these pictures that show the earlobe is perfused by both the anterior and posterior arteries. The crease shows up right in the middle of where these two arteries perfuse the earlobe. Could lack of blood flow related to narrowing of those arteries leads to tissue atrophy?

I think that's a plausible explanation don't you

My aim is to help clinicians and people wanting to understand their risk for disease to understand the actions that can be taken when the auricular crease is identified. I will demonstrate: populations in which the diagonal earlobe crease is significant and in which populations it is not likely significant; the physiology of why the diagonal crease forms in some people and not others; diagnostic tests that one may want to speak about with their licensed healthcare provider; dietary and lifestyle that may lead to the underlying diseases and how to avoid them and a story from one man who took Frank's Sign seriously, when his doctor dismissed it, and sought further evaluation that led to an important diagnosis.

 Infographic retrieved from:

This article is a work in progress like all of my blog posts. Subscribe to my blog to stay up to date on my work if you find it of interest. You can also follow me on Twitter and Instagram @nurseericyeah To your health... Cheers!