Warning Function of Frank's Sign in Pre-Existing Cardiac Disease Patients: A Case Report.
Mingzhe WangYujing ZhangJiang HuangGeping LiaoWei QianYaofu ZhengXiaoping PengJianbing ZhuPublished in: Case reports in cardiology (2024)
Frank's sign (FS) refers to a diagonal skin fold between the tragus and the outer edge of the earlobe. FS has been identified as an independent variable in coronary artery disease (CAD). Young patients with FS and previous myocardial infarction are still rarely reported in clinical studies. We report the case of a 49-year-old male smoker and diabetic, with a history of myocardial infarction, who presented to the emergency department due to 2 h typical cardiac chest pain. His urgent electrocardiography (ECG) showed ST elevation, and cardiac biomarkers were elevated after admission. A diagonal earlobe crease (DELC) was observed in physical tests. The preliminary diagnosis considered acute coronary syndrome (ACS). Subsequently, acute coronary artery angiography demonstrated a slit-like contrast defect in the proximal right coronary artery (RCA), with stenosis and occlusion in the distal segment. The percutaneous coronary intervention (PCI) was performed immediately. The patient's chest pain symptoms were relieved significantly after intervention. Our case indicates that FS should be highly regarded as a routine cardiovascular clinical examination, which can be effortlessly applied and be easily interpreted for screening to suspect the presence of ischemic heart disease. This may set strategies for primary screening in a younger population and prompt early diagnosis and treatment.
Keyphrases
- acute coronary syndrome
- percutaneous coronary intervention
- coronary artery disease
- coronary artery
- left ventricular
- emergency department
- antiplatelet therapy
- st segment elevation myocardial infarction
- acute myocardial infarction
- st elevation myocardial infarction
- coronary artery bypass grafting
- pulmonary artery
- heart failure
- cardiovascular events
- end stage renal disease
- randomized controlled trial
- ejection fraction
- magnetic resonance
- chronic kidney disease
- optical coherence tomography
- newly diagnosed
- mental health
- type diabetes
- liver failure
- cardiovascular disease
- computed tomography
- respiratory failure
- atrial fibrillation
- coronary artery bypass
- heart rate variability
- clinical practice
- minimally invasive
- physical activity
- peritoneal dialysis
- depressive symptoms
- pulmonary arterial hypertension
- prognostic factors
- case report
- magnetic resonance imaging
- aortic stenosis
- contrast enhanced
- intensive care unit
- transcatheter aortic valve replacement
- drug induced