12-lead EKG showed sinus rhythm 75 bpm with ST segment elevation in the upper lateral leads (I and aVL) and V2 with reciprocal ST segment depression/T wave inversions in the inferior leads (most pronounced in lead III) consistent with diagonal/ramous intermedius branch 100% acute occlusion (South African flag sign).

I am not certain why the patient was not taken to the cath lab after the initial EKG.