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EKG of the Month for August 2008

A 55-year-old man is brought in by PD after being found down and apparently intoxicated.
He has a history of binge drinking but no history of cardiac disease.
Upon your initial assessment, in addition to his obvious inebriation, he states the police kicked him in the chest and his chest hurts.
His chest shows no sign of trauma. Oxygen is started, intravenous access is obtained, and a 12-lead ECG is obtained.

The nurse hands you the ECG. The computer reading shows a ventricular rate of 71 beats/min; PR interval, 183 ms; QRS duration, 96 ms; QT/QTc interval, 400/435 ms; P axis, 56 º; R axis, 21º; and T axis, 45º;

What is your interpretation of this ECG?

Answer