This month's ECG was taken from a 50yo male who presented with severe central crushing chest pain radiating to the neck and jaw associated with nausea and sweating.  The Pain wa apparently precipitated when mobilising to the toliet and was not eased by taking GTN.  He has a past medical history of diabetes and smokes 20/day.  O/E he is diaphoretic, looks distresed, HR 75 regular, RR 24, BP 210/110, Temp 36.9, Chest had good air entry with no signs of pulmonary oedema (JVP or creps), HS I + II + O. Nil else abnormal on examination. 

What critical piece of information is lacking when interpreting the ECG below and what are your findings?  

If the above piece of information was available what treatment option would you consider and what other eligibility criteria would you need to know first?

How would you assess the effect of such a treatment?

Answers will be available shortly!