ECG of the Week - 9th December 2013

This week's ECG is from a 58 yr old male who presents to the Emergency Department c/o palpitations, dizziness, and chest pain. Symptoms onset ~90 mins prior to presentation.
Past Hx - hypertension, hyperlipidaemia. 

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VAQ Corner

A 58 yr old male presents to your Emergency Department c/o palpitations, dizziness, and chest pain. Symptoms onset ~90 mins prior to presentation. Past Hx - hypertension, hyperlipidaemia. 
Vitals: BP 103/67 RR 18 Sats 97%

a) Describe & interpret his ECG (50%)
b) Outline your further management (50%)