A 72-year-old woman presents for her first clinic visit with a new primary care provider. She has a history of hypertension and diabetes and suffered a myocardial infarction 18 months earlier. She is currently feeling well but does note heartburn on a nearly daily basis when she lies down to go to sleep at night.
Concerned about her heartburn symptoms possibly being related to cardiac ischemia, her primary care physician obtains an ECG.
What does her ECG show?