It’s a surprisingly busy Sunday shift and you are reviewing a 72 year old lady with a background of hypertension who has presented with chest heaviness radiating into the arms, back and neck. She had experienced the back pain the day before and woke with new chest pain in the morning. On examination she looks pale and has a pacemaker scar but there is nil else to find.

Her ECG is as below:

Questions:

1. Interpret the ECG
2. Describe your management.