One such external indicator is diagonal creases on the earlobes – known as Frank’s sign, named after Sanders Frank, an American doctor who first described the sign.
Studies have shown that there is an association with the visible external crease on the earlobe and increased risk of atherosclerosis, a disease where plaque builds up inside your arteries.
It is not clear what the cause of the association is, but some have postulated that it is to do with a shared embryological origin. Most recently, it has been seen that these creases are also implicated in cerebrovascular disease – disease of the blood vessels in the brain.
Another external indicator of heart issues is yellow, fatty bumps known clinically as ‘xanthomas’ that can appear on the elbows, knees, buttocks or eyelids. The bumps themselves are harmless, but they can be a sign of bigger problems.
The mechanism that causes these fatty deposits in tissues is understood and it holds an iconic place in medicine as it led to the development of one of the blockbuster group of drugs that reduce cholesterol – statins.
A phenomenon known as digital clubbing may also be a sign that all is not well with your heart. This is where the fingernails change shape, becoming thicker and wider, due to more tissue being produced. The change is usually painless and happens on both hands.
The reason this change indicates heart issues is because oxygenated blood is not reaching the fingers properly and so the cells produce a ‘factor’ that promotes growth to try and rectify the issue.
Halo around the iris
Fat deposits may also be seen in the eye, as a grey ring around the outside of the iris, the coloured part of the eye. This so-called ‘arcus senilis,’ starts at the top and bottom of the iris before progressing to form a complete ring. It doesn’t interfere with vision.
About 45% of people over the age of 40 have this fatty halo around their iris, rising to about 70% of people over the age of 60. The presence of this fatty ring has been shown to be associated with some of the risk factors for coronary heart disease.
Rotten gums and loose teeth
The state of your oral health can also be a good predictor of the state of your heart health. The mouth is full of bacteria, both good and bad. The ‘bad’ bacteria can enter the bloodstream from the mouth and cause inflammation in the blood vessels, which can lead to heart disease.
Studies have shown that tooth loss and inflamed gums (periodontitis) are markers of heart disease.
Another health indicator from the mouth is the colour of your lips. The lips are usually red, but they can take on a bluish colour (cyanosis) in people with heart problems, due to the failure of the cardiovascular system to deliver oxygenated blood to tissues.
Of course, people also get blue lips if they are extremely cold or have been at a high altitude. In this case, blue lips are probably just due to a temporary lack of oxygen and will resolve quite quickly.
In fact, the other five symptoms, mentioned above, can also have a benign cause. But if you are worried or in doubt, you should contact your GP or other healthcare professional for an expert opinion.