Doctors, nurses any one please help. Reading an ECG?

Ya, ECG looks like ST-segment elevation so you got an acute coronary syndrome likely due to ruptured coronary plaque and platelet aggregation/thrombosis leading to decreased blood flow and oxygen supply resulting in ST elevation myocardial infarct. Its obvious without looking at the ECG that guy has acute coronary syndrome and ischemic heart disease. He's already taking nitrostat for chest pain for acute ischemic episodes and has shortness of breath upon exertion so you might predict he has existing stable chronic angina. ECG just helps identify which type of ACS he may be experiencing, STEMI or NSTEMI along with other arrhythmias which I don't have much experiencing looking at ECGs. A little confused as to what exactly your question is since it tells you he has SOBOE and chest pain and these are obviously the textbook clinical symptoms you ask about to identify ischemic heart disease and acute coronary syndrome.