i

i

Althought septal, anterior and lateral infarction can not be excluded in this tracing, several features suggest that the findings represent pseudo-infarct pattern resulting from chronic obstructive lung disease.

In this case:

- P pulmonale is present,

- the presence of dominant S waves across the precordium and low voltage of the R wave in V6 are strongly suggestive of pulmonary disease,

- the prominent S waves in the lateral precordial leads and the terminal R wave in V1 and V2 are also suggestive of chronic pulmonary disease.