Answer for December 19, 2012
An acute or sub-acute postero-apical infarction is present. Note the tall R wave in V2 with ST depression. This is actually a Q wave and ST elevation posteriorly (if you are uncertain about this, print the EKG, hold the sheet up to the light and view the sheet upside down from the non-printed side). There is some ST elevation in V5 and V6. This infarction is probably due to a circumflex lesion, or a right coronary dominant apex with a right coronary lesion affecting the posterior descending.
NOTE: EKG's are for internal educational purposes of the University of Massachusetts Department of Family Medicine. Please do not forward without permission from Dr. Golding!