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Diagonal earlobe creases that extend from the tragus across the lobule of the ear is a recognized sign of coronary artery disease.
Diagonal earlobe creases is defined as a line covering at least 1/3 of the length between the tragus and the posterior inferior lobe edge.
There is a 3.3 fold higher risk of coronary artery disease in individuals with diagonal earlobe creases compared with those patients without such creases.
Diagonal earlobe creases are independently associated with cardiovascular events such as ischemic stroke.
Angiographic findings support the association of coronary artery disease and such ear creases.
Both the earlobe and the myocardium are supplied by end arteries without collateral circulation.
Earlobe tissues might be subject to diminished blood supply similar to myocardial tissues, leading to premature distraction of elastic fibers that manifest as diagonal ear lobe creases.
Sun damage and smoking are not associated with diagonal ear lobe creases.
Diagnostic importance is more significant when accompanied by risk factors for coronary artery disease such as hypertension, hyperlipidemia, dyslipidemia, elevated creatinine levels, smoking, diabetes, and a family history of coronary artery disease.