ST segment and T wave changes

What is the cause of ST changes and T wave inversions in this ECG?

Should the patient be taken to Cath lab for coronary angiography?

These ST segment and T wave changes are secondary to left ventricular hypertrophy.
There are classical features of left ventricular hypertrophy in this ECG which should not be missed.
Hence, if the patient doesn't have any other features which suggest ischemia, then he should undergo evaluation for cause of left ventricular hypertrophy.
The most common cause for left ventricular hypertrophy is hypertension.