Yeah i dont have any education in 12 leads, only what i have picked up myself. ST elevation in Ld II, III and aVF would tell me that there is an occlusion of a distal part of the left anterior descending arter. INferior AMI's have have a 45% to 55% (depending on what your reading) involvement of the righ ventricle. reducing preload any further and its reduction in ventricular stretch, reduction in left atrial and then left ventricular filling, you might not get enough left ventricular pressure on systole to open your aortic valve. ST depression in V3,4,5 and 6 would indicate some posterior involvement, diagnoal branchs of the left circumflex? You could move V1,2 and 3 and run a another 12 lead, re-labelling them for a 15 lead to get the posterior view.
Looked like a 1st degree block too.
Have o experience of fibrinolytic, but if the pt qualifies for it i'd give it, sounds like a hell of a long time to difinitve treatment for a STEMI.
As for the pain redcutionfrom increased B/P, i dont really know, im at the limit of my brains right now, had a terrible day at work :?
Feel free to correct me