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What is Chapman's sign?

S Serge Barold1

  • 1University of Rochester School of Medicine and Dentistry, 601 Elmwood Av, Rochester, NY 14642, USA.

Journal of Electrocardiology
|October 28, 2024
PubMed

Insights

Chapman's sign, a notch on the R wave, aids in diagnosing myocardial infarction (MI) during left bundle branch block (LBBB) or cardiac pacing. This electrographic finding is useful when other MI indicators are absent.

Area of Science:

  • Cardiology
  • Electrocardiography
  • Diagnostic Medicine

Background:

  • Chapman's sign is an electrographic notch on the R wave in specific leads (I, aVL, V6).
  • Its utility in diagnosing myocardial infarction (MI) during left bundle branch block (LBBB) and cardiac pacing has been debated.
  • Previous studies show conflicting results regarding its diagnostic value.

Purpose of the Study:

  • To evaluate the diagnostic usefulness of Chapman's sign for myocardial infarction (MI).
  • To assess the sign's role in specific clinical contexts: left bundle branch block (LBBB) and cardiac pacing.
  • To determine if Chapman's sign can aid MI diagnosis when other signs are not apparent.

Main Methods:

  • Electrocardiographic analysis focusing on Chapman's sign.
  • Review of studies investigating the sign's correlation with myocardial infarction.
  • Analysis of diagnostic accuracy in patients with left bundle branch block or undergoing cardiac pacing.

Main Results:

  • Chapman's sign is characterized by a notch on the ascending limb of the R wave.
  • Conflicting results exist regarding the sign's overall diagnostic accuracy for MI.
  • The sign demonstrates potential utility in diagnosing MI during LBBB or pacing, especially when other MI manifestations are absent.

Conclusions:

  • Chapman's sign can be a valuable diagnostic tool for myocardial infarction.
  • Its usefulness is particularly noted in the presence of left bundle branch block or cardiac pacing.
  • The sign can provide crucial diagnostic information in cases lacking other clear indicators of MI.

Keywords:
Cardiac pacingChapman's signElectrocardiographyLeft bundle branch blockMyocardial infarction

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