Chapman and Pearce reported changes in the ECG that can be seen with acute myocardial infarction in a patient with left bundle branch block (LBBB).

Patient selection: left bundle branch block


Diagnosis: acute myocardial infarction (AMI)


ECG changes in Chapman's sign:

(1) early notching (in the upslope) of the R wave in leads I, aVL or V6

(2) notching of the S wave in leads aVF or V4

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