ECG of the Week 28th December 2022

This is one of the serial ECGs on a 66 year old man who presented to ED following post-coital exertion. He has a history of multiple myeloma diagnosed 5 years ago and receives 4 weekly cycles of Carfilzomib/Dexamethasone therapy but has no other medical history. On the mention of having a heart attack, the patient states he does not want to be resuscitated. Please interpret the ECG and lists your next steps in the management of this patient.