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1. ST elevation in II, III, aVF (inferior leads). III > II, suggesting circumflex originating from LAD. Widespread reciprocal changes in high lateral leads and sternal leads.
2. Bifid p-waves most visible in V2, V3 suggesting p-mitrale.
3. Other: No pathological Q-waves indicating previous AMI. Heart block usually accompanies inferior AMI, especially if right dominant. Not visible here. Normal axis and sinus rhythm, HR = 100bpm. Normal PR interval, QRS width, and RR interval. Criteria for LVH not met.
4. ECG taken at 9:40pm, indicating clinical urgency. Not a routine ECG.
Diagnosis: left dominant inferior AMI. No indication of pre-existing heart disease apart from possible left atrial enlargement. Very young patient (40yo!).