Intermittent Chest pain with Nausea and Vomiting, resolved at this moment

This is fromAmandeep ( " Deep " ) Singh.  Dept Emergency Medicine, Highland Hospital, Oakland.Case51 yo male who walked to a parked fire engine complaining of nausea and vomiting. Per patient, he started feeling nauseous when he woke up, and shortly after, vomited.  On arrival at the emergency department, he reports that he has had intermittent episodes of chest pain associated with nausea and shortness of breath over the past 3 days.  These episodes last about 20 minutes before spontaneous resolution.  He states that he is no longer having any chest pain, difficulty breathing, or nausea right now.Here is his first ECG obtained in the ED. The initial physicians interpreted with ECG as “no ST segment elevation” and ordered a cardiac work-up on the patient.What do you think? There are several subtle abnormalities on this ECG.  The inferior leads show a Q wave, a fragmented QRS, subtle horizontal ST segment elevation (compared to PQ line), and T wave inversion.  Lead I and aVL have a trace amount of ST depression and a slightly positive T wave.  Lead V2 has a trace amount of ST depression and the hint of a prominent T wave.  There is T wave inversion in V6.  These findings are suggestive of a partially reperfused inferior-posterior MI and correlate with the resolution of his symptoms._________Smith comment: this was sent to me with no information, and I responded:" Reperfusion of inferior and lateral ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs