Cardiovascular manifestations and heart attacks are the leading causes of death worldwide, especially among the middle-aged and elderly populations. The severity of the disease is due to the sudden onset without any prior signs or symptoms. Even if symptoms appear, they are misinterpreted for other common heath ailments like indigestion or heartburn. A heart attack occurs when an artery supplying the heart with blood and oxygen becomes blocked due to fatty depositions that build over time, forming plaques in the arteries. This plaque rupture forms a blood clot that blocks the arteries causing a heart attack. Early detection and symptomatic prevention can prevent mortality and reduce the risk of associated health complications.
Heart attack is a severe clinical condition triggered by several risk factors. According to the Mayo Clinic, the elderly population, men aged 45 and older and women aged 55 and older, are more prone to cardiovascular ailments and are at greater risk of heart attack than the younger population. Additionally, people with pre-existing medical conditions such as high blood pressure, high cholesterol, obesity, diabetes, and metabolic syndrome are more susceptible to a heart attack. Moreover, dietary patterns and lifestyle habits such as tobacco use, alcohol consumption, physical inactivity, stress, and an unhealthy diet also contribute to the elevated risk of a heart attack.
Chest pain or pressure is the most common symptom of a heart attack; however, people suffering from a heart attack may experience a variety of conditions such as jaw pain, sweating, heartburn, shortness of breath, toothache, headache, nausea, and vomiting. However, heart attack symptoms vary for men and women, and researchers believe that female sex hormones play a role in heart function and pain perception. For men experiencing a heart attack, symptoms typically include chest discomfort, pain in the upper body (also in one or both arms), shortness of breath, nausea, and dizziness. On the other hand, women, along with the above-mentioned symptoms, may also have a squeezing sensation in the chest, light-headedness, and numbness or tingling in one or both arms. Many women reported pain in the face, neck, jaw, back, ears, or around the earlobe.An unusual symptom of a heart attack is the appearance of creases on the earlobes, known as Frank’s Sign, named after Sanders Frank, an American doctor. The US National Library of Medicine National Institutes of Health studied the link between diagonal earlobe creases and fatal cardiovascular diseases, and more than 40 report analyses have demonstrated an association between the visible external crease on the earlobe and an increased risk of atherosclerosis. Most recently, it has been observed that these creases are also implicated in cerebrovascular disease, a disease of the blood vessels in the brain.
Frank's sign is characterized by a diagonal earlobe crease (DELC) that extends backward from the tragus across the lobule to the ear edge of the auricle at an angle of 45 degrees. It has been described as a dermatological marker and a prominent clinical sign of coronary artery disease. Several studies have unveiled the link between Frank’s Sign and cardiovascular disorders and other vascular diseases (peripheral and cerebrovascular), with a sensitivity of 62.1% and 69.2% for severe coronary atheroma and specificity of 65.9% and 78.0%, respectively, for men and women.
A large population prospective study has shown a significant association of Frank's sign with increased risks of ischemic heart disease and myocardial infarctions, and hence, it was assumed to be a valuable tool to predict the severity of coronary artery disease. Frank's sign shows the possibility of being an independent risk factor and is a useful diagnostic physical examination finding in adults less than 60 years of age. Reliable clinical correlations that predict atherosclerosis are needed to identify at-risk patients. Thus, a detailed inspection of the earlobes should be considered an integral part of the physical examination in clinical practice for patients with suspected coronary artery disease.
In addition, several other reports suggest that Frank's sign could also be a predictor of cerebral infarctions, concomitant with premature aging and the loss of dermal and vascular fibers. Clinical analysis reveals that the cause of death in patients with Frank’s sign, although predominantly cardiovascular, also included malignancy, pulmonary diseases, respiratory infections, and peptic ulcer disease.
Researchers from the University of Toledo (Ohio) acclaim cardiac otalgia, or ear-pain an indicator of heart ailments and stated it as a predominant factor in women, people with prolonged diabetes, and persons with severe cardiac manifestations. A dull ache or throbbing may be a signal of the ear, sinus, or dental infection, but a sharp or burning ear pain in both ears without the signs of any infection, inflammation, or redness, may indicate cardiac distress. However, according to a clinical survey, out of almost 200 cardiac patients in one multi-center study, only 11 had cardiac otalgia.
According to researchers and scientists, heart attack stimulates certain nerve fibers in the nervous system. Since the Vagus nerve (a major nerve of the heart) also excites a nerve called Arnold's nerve, which runs around the ear and face, the alarm signals are deciphered by Arnold nerve receptors and are interpreted in the brain as ear pain; rather than chest pain. Another reason for ear pain during a heart attack can be attributed to autonomic dysfunction of vagus nerves caused due to decreased blood supply and damage, manifested by occlusion of the right coronary artery, which leads to ear fullness and is referred to as a pain in the ear.
To Conclude –
A heart attack is life-threatening and needs emergency attention. It is a critical medical emergency, and in absence of suitable treatment, it can lead to a cardiac arrest resulting in the death of the patient. Spotting the early signs of a heart attack and getting prompt treatment is crucial to avert the fatal outcomes. It is, therefore, necessary for people, especially cardiovascular patients, to be vigilant about the varied symptoms and be aware of the preliminary measures to avert cardiac manifestations. The life sustenance of cardiac patients can be largely increased by well-timed detection and effective treatment. Delaying treatment, however, dramatically reduce the chances of survival. Since heart attacks can be fatal, it is crucial to recognize the warnings as soon as possible and contact emergency services.