Clinical History 74

Sixty-four year old gentleman who presented to the emergency room with a two week history of bilateral arm discomfort and numbness. This escalated immediately before presentation and the accompanying electrocardiogram was obtained. An urgent cardiac catheterization demonstrated a 90% proximal left anterior descending coronary artery stenosis, an 80% left circumflex coronary artery stenosis and an 80% right coronary artery stenosis. Left ventriculography demonstrated antero-apical and infero-apical myocardial infarctions and overall moderate left ventricular systolic dysfunction. The patient was treated medically without further cardiac intervention.
Comment on this ECG ?