ECG Case #25 - Question #1

A 72 year old male with a history of severe COPD on home oxygen, HTN, and coronary artery disease presents to the emergency room with a COPD exacerbation. Blood pressure is 140/85, heart rate is 130, oxygen saturation is 91% on 2 liters oxygen by nasal canula. Physical examination reveals decreased breath sounds and heart sounds. A widened AP diameter of his chest is noted. His ECG is below:

What are the ECG findings?