Abstract
A 59-year-old man with a long smoking history presented with sudden back
pain. Frank’s sign was noticed in his bilateral ears, and computed
tomography revealed Stanford type A acute aortic dissection. If young
patients have Frank’s sign, attention should be paid to aortic disease
in addition to coronary artery disease.
A 59-year-old man with a 40 pack-year smoking history presented our
hospital with sudden back pain. He had no remarkable past medical
history. The blood pressure in the left arm was 30 mmHg higher than the
right arm,
and
bilateral
earlobes
had a diagonal crease
running
across the earlobes at a 45° angle (Frank’s sign; Figure 1). A
contrasted computed tomography showed Stanford type A aortic dissection
(Figure 2), whereas there was no significant calcification in the
coronary arteries. The patient underwent total arch replacement for
aortic dissection. Although he suffered from perioperative stroke with
left arm paralysis, the symptom recovered, and he was transferred to
another hospital for long-term rehabilitation.
Frank’s sign is caused by arteriosclerosis and is known to be associated
with cardiovascular events, especially coronary artery disease, and
should be paid more attention to when seen in people under the age of
60. [1] Among the dead cases with Frank’s sign, 12.3% were reported
due to aortic disease. [3] The factors contributing to
atherosclerosis, such as hypertension and smoking, are also strong risk
factors for aortic disease, including aortic dissection. Frank’s sign in
young people, in addition to coronary artery disease, the aortic disease
should be noted.