49 y m presents to the Emergency Department complaining of shortness of breath. He has a history of hypertension and high cholesterol but is placed in the asthma booth because he is thought to be having an asthma exacerbation. He receives an albuterol and is feeling clinically better but the medicine chief is suspicious that the lack of an asthma history may suggest his dyspnea is due to a different etiology. He gets the EKG found below. Click on the picture for an enlarged view.
How would you interpret this EKG? How do you manage this patient? Let the conversation begin!