All ECG 86
- Accelerated junctional rhythm
- Left bundle branch block
- Chapman's sign indicating possible acute myocardial infarction
Chapman's sign is used to diagnose an acute myocardial infarction in the setting of a left bundle branch block and consists of a notch in the upslope of the R wave in lead I, aVL or V6. This has a low sensitivity, but a specificity of about 90%.
Historically it has been taught that detecting myocardial ischemia is not possible on an ECG in the setting of a left bundle branch block, however there are three different changes that can be seen in this setting suggesting an acute myocardial infarction. These include the Sgarbossa criteria, Chapman's sign and Cabrera's sign. Click the left bundle branch block review below for details.