42 year old with stabbing chest pain

A 42 year old man presents to the emergency department around midnight after playing soccer with some friends. Through mime and smartphone he is able to complain of intermittent stabbing chest pain around the position of ECG lead V4. The patient is new to the country and doesn't speak English very well but does have a medic-alert bracelet that is translated: "Allergy to shellfish. Stents in heart."
This ECG is performed and  placed in front of you, what is going on here?

Answer to come!