A 69-year-old man with a history of coronary artery disease was admitted to the emergency department for acute chest pain. A few minutes after admission, cardiac arrest occurred. Return of spontaneous circulation was obtained after defibrillation and intravenous amiodarone. Post–cardiac arrest ECG revealed a left bundle branch block. Emergency coronary angiography revealed an acute occlusion of the middle segment of the right coronary artery, with successful recanalization after thrombectomy and angioplasty. On ICU admission, an attentive physical examination showed a bilateral marked diagonal earlobe crease ( Figure ).

Diagonal earlobe crease running backward from the tragus at a 45-degree angle across the lobule to the rear edge of the auricle.