Answer:
An EKG tells us about how electricity flows through the cells of the heart. Any infarction of cardiac tissue causes changes in the way the electricity travels. An EKG can show us these changes and help us to even identify where the infarction is occurring.
A 12 lead EKG must be done to truly identify any infarction. The 12 lead shows us 12 different views of the electricity as it moves from one lead to another. By comparing the views we get against what would normally be expected and comparing each lead to the others we can look for changes in the EKG pattern (ST elevation or depression is the most obvious, but many other changes exist).