Heart Disease Risk Factors: Beware the Diagonal Earlobe Crease

by Dr. Stephen Parker (Article selection and Commentary) on January 23, 2011

It is hard to know what to believe these days. Medical research is frequently biased (often by drug money) and off the mark.
Since the 1980’s, articles have been appearing about the “diagonal ear crease” (pictured below) and heart disease and mortality due to heart problems. Some physicians dismiss it as related to aging; however, a number of studies seem to control for this variable.

My conclusion after reviewing the literature? (There are more than thirty articles.) It is more likely than not that there is some correlation between the diagonal ear crease and heart issues.

92871 Heart Disease Risk Factors: Beware the Diagonal Earlobe Crease

Diagonal Ear Lobe Crease and Atherosclerosis: A Review of the Medical Literature…


A significant number of individuals die from atherosclerotic disease of the coronary and carotid arteries without having classic risk factors and prodromal symptoms. A diagonal ear lobe crease (DELC) has been characterized in the medical literature as a marker that can identify high-risk patients having occult atherosclerosis. The oral and maxillofacial surgery literature, however, offers very little information on the subject.
Materials and Methods

The authors conducted a MEDLINE search using the key terms “earlobe crease,” “ear lobe crease,” “atherosclerosis,” “cardiovascular disease,” and “cerebrovascular disease.” They selected articles published in peer-review journals and gave preference to articles reporting randomized controlled trials.

A majority of clinical, angiographic, and postmortem reports support the premise that DELC is a valuable extravascular physical sign able to distinguish some patients at risk of succumbing to atherosclerosis of the coronary arteries. Of particular interest to oral and maxillofacial surgeons is the reported association between individuals with DELC and the development of morbid cardiovascular events associated with the administration of general anesthesia. More recently, reports using B-mode ultrasound have also linked DELC to atherosclerosis of the carotid artery, and another report has related DELC to the presence of calcified carotid artery atheromas on panoramic radiographs. A minority of studies have, however, failed to support the association between DELC and atherosclerosis.

DELC is readily visible during presurgical/preanesthetic physical examination and, in conjunction with the patient’s medical history, vital signs, and panoramic radiograph, may assist in risk assessment and the identification of individuals needing further evaluation.

For the doubting Thomas’s amongst the readers, here are some links:

Increased all-cause and cardiac morbidity and mortality associated with the diagonal earlobe crease: a prospective cohort study.

Diagonal earlobe creases and fatal cardiovascular disease: a necropsy study.

The earlobe crease, coronary artery disease, and sudden cardiac death: an autopsy study of 520 individuals.

Diagonal earlobe crease as a marker of the presence and extent of coronary atherosclerosis.

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