This 57-year-old diabetic man was admitted with a non-ST-elevation MI, and found to have significant lesions of the main-left and circumflex coronary arteries:

• Chest leads placement error (V1-V5 reversal)
• Sinus rhythm
• Low T wave voltage in the inferior leads

He underwent successful double bypass operation, and the following ECG was recorded in the ICU one day after surgery:

• Compared with the pre-operative ECG, there is now diffuse ST elevation
• Consider post-operative pericarditis or injury