Typical chest pain and an ominous ECG

A middle-aged man in his 50s presented to our emergency department with retrosternal chest discomfort of 2-hour duration. His cardiovascular risk factors included smoking and hypertension. The patient had no history of similar episodes. On examination, his heart rate was 72 beats per minute, and his blood pressure was 114/74 mm Hg. The rest of the physical examination was unremarkable. The ECG at presentation is shown in figure 1. A qualitative troponin assay at the time of presentation was negative. Figure 1 Twelve-lead ECG at presentation. 1. Which of the following coronary artery lesions is responsible for this specific ECG pattern ? 1. Proximal site of left anterior descending artery. 2. Proximal site of …