ECG of the Month: Right Bundle Branch Block and Myocardial Infarction

An 81-year-old male presents with a history of diabetes mellitus, chronic obstructive pulmonary disease (COPD), lung cancer, S/P radiation therapy, end stage kidney disease, and coronary artery disease with a recommendation to have coronary artery bypass graft (CABG). The patient complains of weakness and shortness of breath. He decides to spend time in a skilled nursing home facility before undergoing CABG.

An ECG is performed (Figure 1).

Figure 1

Figure 1

The ECG shows which of the following?

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