A 70-year-old woman with known diabetes mellitus presenting with dyspnea, nausea and feeling of impending doom. ECG shows?

Ans. (a) Myocardial infarction.* This tracing reveals sinus tachycardia at a rate of 100 beats/ min. The axis is normal.* Complete right bundle branch block is present, with a qR complex in VI and broad terminal S wave in V6 and lead I. There are pathologic Q waves in the septal leads of V1 and V2 with ST-segment elevation in leads V1 through V4.In this tracing, however, note the pathologic Q waves, ST elevation, and upright T waves in the anteroseptal leads. Conclusion is anterior ST elevation myocardial infarction in the setting of preexisting RBBB.