Acute Coronary Syndrome (ACS): The presence of inverted T waves in leads 2,3, and AVF, along with hyperacute P waves, suggests myocardial ischemia or infarction, which is a hallmark of ACS. The A wave in these leads may indicate atrial enlargement or increased pressure, which can be seen in conditions leading to or resulting from coronary artery disease.

Atrial Fibrillation with Rapid Ventricular Response: Although the question mentions a visible P wave, in some cases, especially if the P waves are buried in the T waves or if there's an irregular rhythm, atrial fibrillation could be considered, especially if there's a rapid ventricular response that could lead to ischemic changes.
Cardiac Chamber Enlargement: Conditions leading to right atrial enlargement (e.g., pulmonary embolism, pulmonary hypertension) could cause prominent P waves (hyperacute P waves), and if there's associated right ventricular strain, it could lead to T wave inversions in the inferior leads.
Pericarditis: While pericarditis typically presents with widespread ST elevation, some cases, especially with associated myocardial involvement, could show T wave inversions. However, the presence of hyperacute P waves would be less typical.

Pulmonary Embolism (PE): A large PE can cause right heart strain, leading to T wave inversions in the inferior leads and prominent P waves due to right atrial enlargement. Missing a PE can be fatal, making it a critical diagnosis not to overlook.
Cardiac Tamponade: Although less common, cardiac tamponade can cause electrocardiographic changes including low voltage QRS, electrical alternans, and potentially T wave inversions in some leads due to the impaired cardiac function. The presence of hyperacute P waves could be seen in conditions leading to tamponade, such as pericarditis.

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): This condition can lead to T wave inversions in the right precordial leads but could potentially affect the inferior leads in advanced cases. It's less likely given the specific lead involvement but should be considered in young patients or those with a family history of sudden cardiac death.
Myocarditis: Myocardial inflammation can lead to a variety of electrocardiographic abnormalities, including T wave inversions and potentially abnormal P waves if there's atrial involvement. However, the pattern described would be unusual for myocarditis.