A 50-something with chest pain.

This was sent by anonymous The patient is a 55-year-old male who presented to the emergency department after approximately 3 to 4 days of intermittent central boring chest pain initially responsive to nitroglycerin, but is now more constant and not responsive to nitroglycerin. It is unknown when this pain recurred and became constant.More past history: hypertension, tobacco use, coronary artery disease with two vessel PCI to the right coronary artery and circumflex artery several years prior.  He reports feeling nauseated with emesis. He reports that this chest pain feels different than prior chest pain when he had his STEMI/OMI, but is unable to further describe chest pain. He denies taking aspirin or antihypertensive medications for the last year and a half.  He denies other symptoms, but remaining history limited given patient emesis. The patient was transported from hallway bed to a room with telemetry. At the time of this HPI, patient was sitting on the edge of his bed and ambulatory. Angiogram in a few years back - type III LAD with LAD 60% disease in mid segment. LCX with moderate disease. Mild disease of RCA.This ECG was recorded in triage.  The computer interpretation is:“Sinus Brady with moderate intraventricular conduction delay, nonspecific t wave abnormality, abnormal EKG”What do you think?This is my interpretation: there is subtle STE in III and aVF.  In aVF it is " coved " (upwardly convex).  ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs