This ECG is from an elderly woman who presented with chest pain and shortness of breath.
This ECG shows ST elevation in V2 with hyperacute T waves in V2-3. Even though this does not meet STEMI criteria, it is highly suspicious. Serial troponins did rise, pain was ongoing and the ECG evolved to meet STEMI criteria. A 100% mid-LAD occlusion was found to be the cause. Echo showed widespread wall motion abnormalities and reduced ejection fraction.