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Cardiology Case Report: Right Leg Pain, Swelling

History:

A patient in their mid-50s presents to the hospital with right leg swelling that started 4 days ago. He reports sudden leg swelling associated with constant 4/10 leg pain. He says his leg feels hard and is making him limp. He denies trauma or excessive exercise, chest pain, SOB, or other complaints.

Exam:

Vital signs are normal except for a pulse in the 120s. The physical exam is notable for tachycardia and a swollen firm leg.

An ECG is performed:

What is the most likely cause of the ECG findings?