Clinical History 157

Forty-three year old woman with a history of sarcoidosis and bronchiolitis obliterans who is admitted to the hospital with a two day history of shortness of breath. Her past medical history includes hypertension and hepatitis C. Medications at the time of this electrocardiogram included prednisone, nebulized inhalers, hydrochlorothiazide, furosemide and potassium.
Comment on this ECG ?