Prepared by Rajeshkumar Bhalodia, MD, Resident, Division of Internal Medicine, and Frank Bleyer, MD, Assistant Professor, Division of Cardiology, Saint Louis University School of Medicine, St. Louis, Mo

Question
A 57-year-old woman came to the emergency department with a complaint of precordial chest pain. Physical examination revealed: heart rate, 106 beats/min; blood pressure, 160/100 mm Hg; temperature, 99.7°F; respiratory rate, 16 breaths/min. Her medical history included hypertension, diabetes, and coronary artery disease (CAD). A stent was placed in her right coronary artery 2 months before presentation. Cardiac examination showed no evidence of jugular venous distention, carotid bruit, or rate or rhythm abnormalities; she had normal S₁ and S₂, without any evidence of murmur. Both lungs were clear to auscultation. Abdominal examination was normal, and the lower extremities had no edema. An electrocardiogram (ECG) was obtained (Figure 1).

How Would You Interpret this ECG?