Lateral wall ischemia

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T wave inversions are seen in leads I, aVL, V4 and V5, indicating lateral wall ischemia. The rate is below 60/ min and the rhythm is sinus (sinus bradycardia). Sinus rhythm is identified by upright P waves with normal PR interval in inferior leads, indicating a supero-inferior activation of the atria. In situs solitus, the sinus P waves are upright in lead I while it is inverted in situs inversus as the sinus node will be on the left side.