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A 57 yr old woman is seen urgently for chest pain of two hours duration. The pain is mild, continuous, aching and localized to the left upper chest and shoulder. No previous cardiovascular problems.

Vent. rate 62 bpm
PR interval 150 ms
QSR duration 76 ms
QT/QTc 408/414 ms
P-R-T axes 240 -64 255

Questions For Thought

1. Does this ECG suggest myocardial ischemia or subendocardial injury? If so, what location?
2. What important intervention is indicated?

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