Red Flags

A red flag is a risk factor; it’s a sign to take a closer look. In my particular profession, I use risk factors as tools to decide whether or not to completed a more in-depth screening for certain diseases. Risk factors don’t mean that someone has a particular disease; but, depending on the risk factor, it can have a stronger association with the likelihood of them having a disease. 

Cardiovascular Disease Red Flag

There is an extensive list of factors that are associated with cardiovascular disease (CVD). Some of them may seem obvious, but others seem way out in left field. None of these risk factors have ever been shown to be causal and they all have varying degrees of sensitivity (or predictive values). But the following are all associated with an increased risk for someone having CVD, a heart attack or a stroke: 

Chronic kidney disease, gallstones, kidney stones, heavy metal exposure, air pollution exposure, working long hours, caring for ill loved ones, dining out frequently, divorce, asthma, migraine headaches, HIV, Hodgkin lymphoma, thyroid abnormalities, erectile dysfunction, various careers like being in law enforcement or the fire service, use of proton pump inhibitors (an antacid medication), Helicobacter pylori infection (the bug that causes stomach ulcers), and blood types B or AB. The risk factors specific to women are: a history of breast cancer, PCOS, bulimia nervosa, pre-eclampsia, gestational diabetes, having given birth to more than two children, miscarriages, early menopause, and menopausal hot flashes.

Red Flags We Can All See

Now the above is not a complete list by any means but it can certainly open one’s eyes to see how connected the entire body is. A lot of risk factors require a provider’s orders for labs or testing. Some risk factors come from looking at someone’s family or medical history then pulling the pieces of the puzzle together with a few pointed questions. But there are a number of risk factors that can be easily recognized in the mirror, or in others with face-to-face conversation.  

Frank’s Sign

Frank’s Sign, also known as diagonal earlobe creases, is something that you might start to notice in people around you. Mel Gibson and Steven Spielberg are two well known individuals who both have Franks’s Sign. Research published in the American Journal of Cardiology shows that Frank’s Sign is associated with a whopping 78% increase in risk for the likelihood of having coronary artery disease.

 

Male Pattern Baldness

Someone once told me that balding is genetic; but, bald is a choice. According to a research article published in the medical journal, Circulation, frontoparietal baldness (around the temples) is associate with a 40% increased risk for cardiovascular disease and increases the risk for having a heart attack. Coronal baldness (crown-top) is associated with a 13% increased risk.

Xanthoma

Xanthomas are localized deposits of lipids (fats like cholesterol) within the organs or just beneath the skin. They are most easily seen around the eyes. They can occur when someone has an underlying cholesterol abnormality. Research has demonstrated that xanthomas predict risk of heart attack, severe arterial disease, and death, independently of other cardiovascular risk factors, including cholesterol.

Fordyce Granules

Fordyce Granules represent ectopic sebaceous glands. Sebaceous glands are normally oil secreting glands. Being ectopic means being in an abnormal place. Fordyce spots are quite common and although though to be harmless, research published in the Journal of Dental Research demonstrated that the presence of these spots are association with increased cholesterol levels. 

Resting Heart Rate

Our resting heart rate (RHR) can give us some meaningful and useful information, like readiness, from our heart rate variability (HRV), or our cardiopulmonary fitness from the rate. But a high RHR has been shown in the research to be associated with a 26% increased risk for CVD in women. And in me, a 3.5-fold increased risk for a sudden cardiac death. 

Technology for Screening

Atrial fibrillation (AF), an irregularly irregular heart rhythm, has long been association with with an increased risk for stroke and even heart attack, especially if not treated quickly. Wearable devices, and bluetooth devices, are able to reliably pick up irregular heart rhythms and bring this to your attention so that you can take action.  

 

Content Credit: Amy Doneen, DNP and Brad Bale, MD – BaleDoneen Method®

 

Physical Signs of Cardiovascular

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