Pilot Has a Flighty Heart

ANSWER

This ECG is consistent with sinus tachycardia, low-voltage QRS complexes, a posterior infarction, and ST- and T-wave abnormalities suggestive of inferior ischemia.

Sinus tachycardia is evidenced by the equal number of P and QRS complexes with a consistent PR interval. QRS complexes of lower amplitude than one would expect for the patient’s body habitus are deemed low voltage.

A posterior infarct is demonstrated by an R wave with no S wave in V₁. Additionally, leads V₂ and V₃ show a pattern of a dominant R wave with ST-segment depressions and an upright T wave.

Finally, inferior ischemia is identified by ST depressions in anterolateral leads I, aVL, V₅, and V₆, and T-wave inversions in inferior leads III and aVF.