Found on the LIFENET.

What is your impression of this ECG?

*** UPDATE ***

Consider this recent case from Dr. Smith's ECG Blog.

ST-elevation in aVR, with widespread ST-depression

"ST elevation in aVR is often thought to represent left main occlusion. However, it really just signifies widespread and diffuse subendocardial ischemia which could be due to left main or 3-vessel disease, or severe proximal LAD disease. Left Main occlusion generally causes rapid death; most who survive left main ACS have some flow and thus often have widespread ST depression."

See also:

63 year old male CC: Chest pain

An unusual case of left bundle branch block