Well it's a pretty crappy ecg,as v4-v6 are cut off, but...

Well it's a pretty crappy ecg,
as v4-v6 are cut off, but I'll give it a go.

Sinus rhythm, regular, rate of about 50bpm.

Notably V2 has mild St elevation with an inverted, almost biphasic t wave, and V3 has TWI so I'd be worried about this being a "Wellen's" syndrome which may indicate a proximal LAD occlusion, especially if there's any history of chest pain.

There appears to be mild STE in leads I and II, with TWI in lead III, none of which fits with a specific coronary distribution for an acute STEMI.

Very tough to interpret overall because of lack of lateral precordial leads but Id be putting the patient in resus, attaching pads, giving aspirin, GTN if there's chest pain and the blood pressure supports it, pulling a trop and calling the cardiologists to consider activating the Cath lab, consider giving ticagrelor and doing serial ecgs.

Again, not giving medical advice, and I'm not a cardiologist, just going through what I'd do if I saw this come in to ED.

The second picture is some sort of raised erythematous papular rash in the deliberate shape of a butterfly, maybe on someone with dermatographia. Maybe secondary to scarification.

I donno tho, I'm bad with rashes.

Next time give me the whole ecg.