There are four parts to this answer

1. The QRS is wide. Does this represent a bundle branch block? Yes. Complete left bundle branch block.
2. Can you diagnose ischemia or infarction from this ECG? Yes. It shows acute anterolateral (subepicardial) injury (acute MI).

81 year old woman presents with substernal chest pain. History of hyperlipidemia. She had a narrow QRS on an ECG in 1987.

Vent. rate 116 bpm
PR interval 178 ms

QRS duration 152 ms
QT/QTc 410/466 ms

P-R-T axes 83 -10 71