A 63-year-old female presents with chest pressure and ST elevation in leads II, III, and AVF on EKG. What is the most likely diagnosis?

The presentation of chest pressure accompanied by ST elevation specifically in leads II, III, and AVF strongly suggests an inferior wall myocardial infarction. The inferior leads monitor the heart's bottom section, and ST elevation in these leads indicates that there is likely ischemia or injury occurring in the inferior part of the heart, typically due to occlusion of the right coronary artery (RCA) in a right-dominant coronary system.

In cases of inferior wall myocardial infarction, patients may exhibit symptoms such as chest pain or pressure, similar to what this patient is experiencing. It is important to correlate the EKG findings with the clinical presentation to establish the diagnosis accurately.

In terms of other potential diagnoses, aortic dissection typically presents with severe ripping or tearing chest pain and may show different EKG changes. Acute pericarditis involves a distinct type of chest pain that is often sharp and related to positional changes, accompanied by diffuse ST elevation across multiple leads rather than localized ST elevation. Pulmonary embolism usually presents with sudden onset of dyspnea or pleuritic chest pain and might show right heart strain on EKG rather than the specific ST elevation observed in this case. Thus, the combination of symptoms and EKG findings aligns most accurately with