Robert E. Lee's Right Ear and the Relation of Earlobe Crease to Coronary Artery Disease

Relation of a diagonal earlobe crease (ELC) to coronary artery disease (CAD) was first reported by Sanders Frank in 1973 more than 100 years after the death of Robert E. Lee. Lee provides a rich description of his symptoms in his letters. Lee lived in a period when scientific medicine was just beginning to develop. CAD was not commonly recognized as a clinical entity by practicing physicians during Lee's lifetime. Numerous studies since Frank's original report have shown how an ELC can add to the predictive probability of CAD in the individual patient. This report provides brief context of the state of medical knowledge of CAD and clinical practice in the 19th century to provide better understanding of Lee's medical history. Photographs of Lee showing diagonal ELC are provided. A review of the medical reports shows the relation of ELC to CAD. Lee's description of his symptoms added to the presence of ELC offer compelling evidence that Lee suffered from ischemic heart disease. In conclusion, a modern observation, the value of ELC in the prediction of CAD, applied to a historical figure provides an example of the importance the observation of an ELC in the evaluation of a patient with suspected CAD and may provide evidence for evaluation of the medical history of other historical figures as well as for our current patients.