A 62 year old male with a history of hypertension presents with chest pains. His blood pressure is 140/90, heart rate 70, respirations 20, and oxygen saturation 98% on room air. His physical examination reveals normal lung sounds, an S4 heart sound and a III/VI holosystolic murmur at the base radiating to the apex. He is still having chest pain. His ECG is below. What are the ECG findings?