PLE-2308

A 54-year-old anxious and diaphoretic male patient presents at the ER, complaining of severe substernal chest pain that is unrelieved by rest. Physical examination reveals bradycardia, and ECG shows ST segment elevation of II, III, aVF. BP is 130/90, HR is 52, and RR is 23. Which of the following is most consistent with the patient’s scenario?