ECG Case 173

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ECG Case 173

A 54-year-old man develops epigastric discomfort and nausea while driving home from his job as a night watchman. The sensation does not abate and when he arrives home he begins to feel diaphoretic and the chest and epigastric pain intensify. He calls emergency medical services, who obtain an ECG immediately upon arrival.

What does his ECG show and what is the likely diagnosis?