A bunch of little things abnormal with this ECG
S1Q3 with maybe a T3
STE in aVR and V1
mild diffuse STD in I, II, aVL, aVF, V3-V6
the R wave transition is early
and there is a PAC with normal conduction and a PAC with aberrant conduction
I vote PE – this ECG has 3 of the 5 common signs consistent with PE.