There are seven parts to this answer

Questions & Answers

1. In what part of the heart is there a problem?

There is both inferior and posterior (subepicardial) injury.

2. What is the differential for the ST-segment abnormality seen in V1 and V2?

The ST-depression in V1 and V2 can be reciprocal change, represent anterior subendocardial injury; OR (as is the case here) posterior subepicardial injury.

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69 year old man with substernal chest discomfort. BP 70 mm Hg. History of HTN.

Vent. rate 64 bpm
PR interval 138 ms
QSR duration 80 ms
QT/QTc 394/406 ms
P-R-T axes 59 55 84