Background: Myocardial infarction (MI) is one of the leading causes of mortality worldwide, including Thailand. The diagnosis of MI relies on typical presentation of chest pain (angina pectoris) and laboratory findings. However, some patients may present with atypical symptoms such as dyspnea, nausea, diaphoresis, weakness, dizziness, or epigastric paincollectively referred to as angina equivalent symptoms. Such presentation can lead to a delay in diagnosis and treatment, resulting in adverse outcomes. This study aims to identify physical signs that can aid in the diagnosis of MI, such sign includes the earlobe crease (ELC).

Objective: To examine the association between the presence of earlobe creases and the incidence of myocardial infarction (MI) in patients presenting to the emergency department.

Method: This prospective cross-sectional study enrolled 173 patients presented with chest pain to the Emergency Department of Rajavithi Hospital from July 2023 to September 2024. Patients were assessed for the presence of earlobe creases and subsequently diagnosed with MI. Data were analyzed using SPSS version 20.

Results: Out of 173 participants, 3 were excluded, resulting in 170 patients (119 males [70%], 51 females [30%], mean age 59.64 ± 15.92 years). ELCs were present in 123 patients (72.4%) and absent in 47 patients (27.6%). The presence of ELCs was significantly associated with the diagnosis of myocardial infarction (p = 0.012). Patients with ELCs were found to have a 3.51-fold increased likelihood of having an MI compared to those without ELCs.

Conclusion: The presence of earlobe creases is significantly associated with myocardial infarction. Patients presenting with ELCs should be considered at higher risk and warrant closer cardiovascular evaluation.