If the eye is a window to the soul, could the ear be a window to the heart?
I recently stumbled upon a blog post written by a doctor about a particular characteristic of the ears that is apparently associated with heart disease. Keep in mind that some doctors espouse some pretty unorthodox views on lavish websites and YouTube channels, so I was appropriately skeptical.
It’s called “diagonal earlobe crease” or DELC for short. George W. Bush has it, as well as Steven Spielberg. It looks like a little slash mark just above the earlobe. Though we are not born with it, this mark starts to appear later in life and becomes more and more common the older we are.
The headline on the doctor’s blog post is certainly arresting: “How to Predict a Heart Attack by Looking at Your Earlobes”! I don’t need to remind you of the special place in Hell reserved for headline writers. No, you cannot predict a heart attack by looking at your earlobes. There is no timestamp on your ear to indicate when your next heart attack will take place. But is there some predictive value in this little mark? As it turns out, yes.
The association between DELC and coronary artery disease was first made in 1973 by Sanders T. Frank, which is why the presence of this crease is also known as “Frank’s sign” in medical circles. Coronary artery disease (CAD) is a subgroup of diseases of the heart and the circulatory system which includes heart attacks. Typically, these diseases are caused by the hardening of an artery that supplies blood to the heart. To be able to easily predict who is at risk for CAD, especially from a simple, noninvasive ear inspection, would be fantastic.
So how useful is the presence of earlobe creases to predicting CAD? This clinical sign has good specificity but poor sensitivity. A test that is 100% specific will never tell you that a healthy person has the disease. Meanwhile, a test that has perfect sensitivity will never tell you that a person with the disease is disease-free. Of course, in medicine, no test has perfect specificity and sensitivity, so doctors favour tests that, all things considered, do well on both of these fronts. A large number of people without earlobe creases have CAD, so the sensitivity is not very good.
Still, the association exists and has been reported by many research groups, though some proclaimed no such relationship in their population, so it may be that this association is not present everywhere around the world, or that the strength of the association varies from population to population.
Why, you may ask yourself, would a particular crease on your earlobe have anything to do with coronary artery disease? The answer is we don’t know. One hypothesis is that both are linked to a loss of elastic fibres which occurs with age.
Having easy access to a cardiologist, I asked him if the detection of earlobe creases was commonly used in his practice. It turns out that Frank’s sign may be closer to Frank’s trivia. Sure, it’s an interesting sign to look out for, but there are much more meaningful risk factors for CAD. A family history, cigarette smoking, bad eating habits, a lack of exercise, obesity, as well as some molecular markers of inflammation can be more informative to a clinician than whether or not you have a diagonal streak above your earlobe.
If the ear is a window to the heart, it is a tiny cruise ship porthole in economy class covered in grease. If you move one floor up, you will find much more spacious windows that will give you a more accurate idea of what’s happening out there.
And before you reach for the knife drawer, cutting out your earlobe will do nothing to reduce your risk of heart disease.
