Clinical History 43

Sixty-five year old gentleman referred for coronary artery bypass graft surgery in the setting of pulmonary edema and advanced coronary artery disease. A recent cardiac catheterization demonstrated moderately severe left ventricular systolic dysfunction and anterolateral akinesis.The most advanced coronary artery obstruction was in the diagonal branch of the left anterior descending coronary artery. Medications at the time of this electrocardiogram included atenolol, aspirin, simvastatin and isosorbide mononitrate. Co-morbidities included hypertension and long-term tobacco use.
Comment on this ECG ?