A Diagnostic Supportive Sign for the Cause of Death Diagonal Ear Lobe Crease
DOI:
https://doi.org/10.17986/blm.2005102586Keywords:
diagonal ear lobe crease, coronary artery disease, death investigationAbstract
Coronary artery disease is a major cause of natural death. The high incidence and mortality of these diseases arised a need to investigate possible risk factors beyond well known. Diagonal ear lobe crease (DEC), was the physical sign, described in 1973. We investigated the possibility of DEC as a helpful predictive sign in the postmortem examination of forensic sudden death cases. The angiographic results revealed that whenever the percentages of the stenosis in left descending coronary artery, circumflex artery and right coronary artery increased, the incidence of the DEC did so accordingly. These results were correlated with the previous studies reporting significant correlation between coronary artery disease and the DEC. Particularly, in the absence of supportive medical history and without a physical sign of trauma, the presence of DEC could well be a supportive sign for the physician to consider the coronary artery disease as a cause of death.
Key words: Diagonal ear lobe crease, coronary artery disease, death investigation
Downloads
References
Saukko P, Knight B. Knight’s Forensic Pathology. 3rd ed. London, 2004:493, 11. DOI: https://doi.org/10.1201/b13642
Elliott WJ. Ear lobe crease and coronary artery disease. 1,000 patients and review of the literature. Am J Med 1983; 75:1024-1032.
Chen WC, Zhao TM, Xue W, Dong CL. Ear lobe crease, high serum cholesterol and human leukocyte antigen, risk factors in coronary artery disease. Chin Med J (Engl) 1982; 95:839-842.
Bahçelioğlu M, Işık AF, Demirel B, Şenol E, Aycan
S. The diagonal ear-lobe crease. As sign of some disease. Saudi Med J 2005; 26:947-951.
Lichstein E, Chadda KD, Naik D, Gupta PK. Diagonal ear-lobe crease: Prevalence and implications as a coronary risk factor. N Engl J Med 1974; 290:615-616. DOI: https://doi.org/10.1056/NEJM197403142901109
Evrengül H, Dursunoğlu D, Kaftan A, Zoghi M, Tanrıverdi H, Zungur M, Kılıç M. Bilateral diagonal earlobe crease and coronary artery disease: A significant association. Dermatology 2004; 209:271-275. DOI: https://doi.org/10.1159/000080847
Patel V, Champ C, Andrews PS, Gostelow BE, Gu- nasekara NP, Davidson AR. Diagonal earlobe creases and atheromatous disease: A postmortem study. J R Coll Physicians Lond 1992; 26:274-277.
Shoenfeld Y, Mor R, Weinberger A, Avidor I, Pink- has J. Diagonal earlobe crease and coronary risk factors. J Am Geriatr Soc 1980; 28:184-187. DOI: https://doi.org/10.1111/j.1532-5415.1980.tb00514.x
Moncada B, Ruiz JM, Rodriguez E, Leiva JL. Letter: Ear-lobe crease. Lancet 1979; 27:220-221. DOI: https://doi.org/10.1016/S0140-6736(79)90629-9
Williams RR. Letter: Myocardial infarction risk, earlobe crease, and sleep apnoea syndrome. Lancet 1989; 2:676-677. DOI: https://doi.org/10.1016/S0140-6736(89)90917-3
Brady PM, Zive MA, Goldberg RJ, Gore JM, Dalen JE. A new wrinkle to the ear-lobe crease. Arch Intern Med 1987; 147:65-66. DOI: https://doi.org/10.1001/archinte.1987.00370010069017
Andresen AR, Christiansen JS, Jensen JK. Letter: Diagonal ear-lobe crease and diabetic retinal angiopathy. N Engl J Med 1976; 294:1182-1183. DOI: https://doi.org/10.1056/NEJM197605202942118
Christiansen JS, Mathiesen B, Andersen AR, Cal- berg H. Letter: Diagonal ear-lobe crease in coronary heart disease. N Engl J Med 1975; 293:308-309. DOI: https://doi.org/10.1056/NEJM197508072930626
Metin M, Uluçam M, Paydak H, Aksoy A, Çengel A, Dörtlemez O, Dörtlemez H. Kulak lobu çizgi- lenmesinin koroner arter hastalığında tanı değeri. Turk J Cardiol 1991; 4:101-104.
Frank ST. Letter: Aural sign of coronary-artery disease. N Engl J Med 1973; 289:327-328. DOI: https://doi.org/10.1056/NEJM197308092890622
Lichstein E, Chadda KD, Naik D, Gupta PK. Diagonal ear lobe crease: Incidence and significance as an coronary risk factor. Clin Res 1973; 21:949.
Fisher JR, Sievers ML. Letter: Ear-lobe crease in American Indians. Ann Intern Med 1980; 93:512. DOI: https://doi.org/10.7326/0003-4819-93-3-512_1
Kirkham N, Murrells T, Melcher DH, Morrison EA. Diagonal earlobe creases and fatal cardiovascular disease: A necropsy study. Br Heart J 1989; 61:361-364. DOI: https://doi.org/10.1136/hrt.61.4.361
Kaukola S, Mannien V, Valle M, Halonen PI. Letter: Ear-lobe crease and coronary atherosclerosis. Lancet 1979; 29:1377. DOI: https://doi.org/10.1016/S0140-6736(79)92868-X
Lichstein E, Chapman I, Gupta PK, Chadda KD, Smith H, Schwartz I, Naik D. Letter: Diagonal earlobe crease and coronary artery sclerosis. Ann Intern Med. 1976; 85:337-338. DOI: https://doi.org/10.7326/0003-4819-85-3-337
Elliott WJ, Karrison T. Increased all-cause and cardiac morbidity and mortality associated with the diagonal earlobe crease: A prospective cohort study. Am J Med 1991; 91:247-254. DOI: https://doi.org/10.1016/0002-9343(91)90123-F
Motamed M, Pelekoudas N. The predictive value of diagonal ear-lobe crease sign. Int J Clin Pract 1998; 52:305-306. DOI: https://doi.org/10.1111/j.1742-1241.1998.tb11636.x
Elliott WJ, Powell LH. Diagolan earlobe creases and prognosis in patients with suspected coronary artery disease. Am J Med 1996; 100:205-211. DOI: https://doi.org/10.1016/S0002-9343(97)89460-0
Tranchesi B, Barbosa V, Piva de Albuquerque C, Ca- ramelli B, Gebara O, Dias dos Santos Filho R, Nakano O, Bellotti G, Pileggi F. Diagonal earlobe crease as a marker of the presence and extent of coronary atherosclerosis. Am J Cardiol 1992; 70:1417-1420. DOI: https://doi.org/10.1016/0002-9149(92)90292-7
Cumberland GD, Riddick L, Vinson R. Earlobe creases and coronary atherosclerosis. The view from forensic pathology. Am J Forensic Med Pathol 1987; 8:9-11. DOI: https://doi.org/10.1097/00000433-198703000-00003
Sprague DEL Diagonal ear-lobe crease as an indicator of operative risk. Anesthesiology 1976; 45:362-364. DOI: https://doi.org/10.1097/00000542-197609000-00023
Wagner RF, Reinfeld HB, Wagner KD, Gambino AT, Falco TA, Sokol JA, Katz S, Zeldis SM. Ear-canal hair and the ear-lobe crease as predictors for coronary- artery disease. N Engl J Med 1984; 311:1317-1318. DOI: https://doi.org/10.1056/NEJM198411153112012
Nyboe J, Jensen G, Appleyard M, Schnohr P. Risk factors for acute myocardial infarction in Copenhagen. I: Hereditary, educational and socioeconomic factors. Eur Soc Cardiol 1989; 10:910-916.
Cheng TO. More research needed on the association between diagonal earlobe crease and coronary artery disease. Arch Intern Med 2000; 160:2396. DOI: https://doi.org/10.1001/archinte.160.15.2396
Cheng TO. Earlobe crease and coronary artery disease: Association or coincidence? Am J Med 1992:93:587-590. DOI: https://doi.org/10.1016/0002-9343(92)90596-4
Mehta J, Hamby RI. Diagonal ear-lobe crease as a coronary risk factor. N Engl J Med 1974; 1:260.
Gibson TC, Ashikaga T. The ear lobe crease sign and coronary artery disease in aortic stenosis. Clin Cardiol 1986; 9:388-390. DOI: https://doi.org/10.1002/clc.4960090806
Eber B, Delgado P. More on the diagonal earlobe crease as a market of coronary artery disease. Am J Cardiol 1993; 72:861. DOI: https://doi.org/10.1016/0002-9149(93)91087-X
Cheng TO. Letter: Ear lobe crease and coronary artery disease. J Am Geriatr Soc 1991; 39:315-316. DOI: https://doi.org/10.1111/j.1532-5415.1991.tb01659.x
Downloads
Published
Issue
Section
License
Copyright (c) 2005 Birol Demirel- Meltem Bahçecioğlu- Taner Akar- Ender Şenol
This work is licensed under a Creative Commons Attribution 4.0 International License.
The Journal and content of this website is licensed under the terms of the Creative Commons Attribution (CC BY) License. The Creative Commons Attribution License (CC BY) allows users to copy, distribute and transmit an article, adapt the article and make commercial use of the article. The CC BY license permits commercial and non-commercial re-use of an open access article, as long as the author is properly attributed.
