MUMBAI: In a country where heart diseases are the biggest killers claiming roughly 1.7 million lives annually, a rural doctor wants to revive the forgotten art of diagnosing cardiac problems by merely taking a closer look at the patient instead of subjecting him/her to a battery of diagnostic tests.The diagonal earlobe crease (DELC) is one of the most visible telltales of a diseased heart, says Dr Himmatrao Bawaskar , who practises in Mahad, 160 km from Mumbai. He studied 888 patients who came with diseases common among Indians, such as diabetes and hypertension, and found that 95% of those who had an “ear crease” had ischemic heart disease (see box). “Of the 888 patients, 508 had an ear crease,” he said.The doctor, whose work in snake and scorpion bites have earned international praise, believes the “ear crease” could serve as a surrogate marker for doctors in resource-crunch settings. “In India, the majority of chest pain victims first go to family physicians. At times, sudden death is the first and last manifestation of IHD,” he said.The ear-crease theory isn’t new. In an era before CT, angios and high-sensitivity blood enzyme tests, American doctor Sanders T Frank “discovered” the ear-heart link in the early Seventies. Dr Altaf Patel, former professor from JJ Hospital’s Grant Medical College in Byculla, said, “The earlobe connection to heart disease seems like a common sense thing.” As people grow older and develop blood pressure, the fat tissues curve up to form a crease. “A majority of people with the an ear crease are in their late 50s or 60s. Most of them will have high blood pressure or heart disease,” added Dr Patel.Dr Bawaskar’s study, which has been accepted for publication in the Journal of Family Medicine and Primary Care, has found a connection between heart disease and height as well. “The height of most Caucasians is 180 cm or more, they have bigger blood vessels and hence have lower incidence of heart disease,” he said. But Indians are shorter and have thinner blood vessels. “In this study, we noted that men with mean height of 166.4 cm and women with mean height of 151.1 cm are more prone to coronary artery disease if they have an ear crease,” he added.In 2017, a study from Israel published in the American Journal of Medicine found ear creases in stroke patients: of the 241 patients hospitalised with a stroke, 79% had “Frank’s sign”, as the ear crease is referred to.Dr Bawaskar is very clear that such surrogate markers could help the rural patients. However, professor and head of cardiology department at J J Hospital, Dr N O Bansal, dismisses the theory. “The correlation has lost its value in modern medicine. People can have the ear crease without heart disease. Moreover, there are diagnostic labs or small hospitals even in remote parts of the country offering ECG to detect heart problems,” he said.

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