The Ups and Downs of One Man’s Life

ANSWER

The correct interpretation includes normal sinus rhythm, evidence of a previous inferior MI, an anterior MI, and lateral ischemia (evidenced by ST- and T-wave abnormalities in the lateral chest leads).

Normal sinus rhythm is demonstrated by the presence of a P wave for every QRS complex and a QRS complex for every P wave, with a consistent PR interval of 72 beats/min. The Q waves in leads II, III, and aVF indicate an old inferior MI.

Progression of proximal LAD stenosis and an anterior MI is evidenced by the ST segment elevations in leads V₁ to V₃, and lateral ischemia is represented by ST- and T-wave abnormalities in leads V₄ to V₆. Note that there are also Q waves in leads V₄ to V₆, which suggest a previously undiagnosed lateral MI.