Clinical History 195

Sixty-five year old gentleman with advanced peripheral vascular disease scheduled for a cardiac catheterization priorto a lower extremity arterial revascularization procedure. This electrocardiogram was obtained at the time of his cardiac catheterization. The cardiac catheterization demonstrated an 80-90% proximal stenosis of a large ramus intermedius coronary artery. Otherwise the coronary arteries were without significant obstructive lesions.
Comment on this ECG ?