Clinical History 75

Sixty-two year old gentleman with recent symptoms of accelerating angina pectoris with a subsequent cardiac catheterization demonstrating severe multi-vessel coronary artery disease. This electrocardiogram was obtained priorto anticipated near future coronary artery bypass graft surgery. His cardiac catheterization demonstrated evidence of an age indeterminate inferior myocardial infarction. Medications at the time of this electrocardiogram included metoprolol.furosemide, digoxin, topical nitroglycerin and captopril.
Comment on this ECG ?