Associate Professor Dr. Smith Srisont, a forensic pathologist, explains the mechanism of death from coronary artery disease found in sudden natural deaths and addresses whether the earlobe crease is related to this condition.
On 21 Aug 2016 GMT+7, a reporter reported that Associate Professor Dr. Smith Srisont, president of the Forensic Medicine Association of Thailand and a pathology lecturer at Ramathibodi Hospital Faculty of Medicine, posted on Facebook. "Smith Fa Srisont" He explained the case of death from coronary artery disease presenting as sudden natural death, which forensic doctors often observe during autopsies. He spoke from the perspective of a forensic physician for both medical professionals and the general public.
He stated that coronary atherosclerosis or coronary artery disease is the top cause of sudden natural death. The death mechanism involves arteries supplying the heart becoming narrowed or clogged by fat or calcium deposits, restricting blood flow. This causes heart muscle death, leading to abnormal heart rhythms and ultimately cardiac arrest. A blockage of 70-75% or more in just one of the three main coronary arteries is sufficient to cause death.
Risk factors include older age, male gender, genetics, high blood pressure, high blood lipids, smoking, diabetes, obesity, lack of exercise, stress, and others. He emphasized this to address common questions from relatives asking why someone developed this disease.
In sudden death cases, the deceased might experience this condition for the first time, leading directly to death. Sometimes, medical history shows the person was healthy with no chronic illness or even under regular medical care, yet tests such as electrocardiograms may show no abnormalities because the heart muscle was still normal.
Although mostly seen in older individuals, this cause of death can occur in younger people. He cited a case in Thailand of a 24-year-old, likely linked to genetically caused high blood lipids. Therefore, if a family member died from heart disease before age 40-45, it is advisable to consult a doctor for lipid screening. The 24-year-old case occurred before COVID-19, so it is definitely unrelated to COVID-19 vaccines.
This disease is different from sudden unexplained death syndrome, which is when no cause is found during autopsy. That syndrome is presumed to result from fatal heart rhythm disturbances, leaving no detectable cause on postmortem examination.
A physical feature associated with this disease is the earlobe crease (earlobe crease / Frank’s sign), as shown in the photo. However, it does not mean that everyone with the crease definitely has the disease, nor does its absence rule out the disease. Such creases can also appear in elderly people without coronary artery disease. He personally believes that if the crease appears in someone under 60, they should consult a doctor to consider testing for the disease.
Source: Facebook page of Smith Fa Srisont