Hafnarstræti 2, 400 Ísafjörður, third floor apartment 3B. A four-story concrete building constructed in 1992. Main entrance is accessible via a coded door, code is 1987. There is an elevator and a central stairwell. Street parking is available. Building is equipped with a basic fire alarm system. Current conditions: 2°C, light snow, moderate visibility. GPS coordinates: 66.0738° N, 23.1252° W. Nearest landmark: Ísafjörður harbor.
65-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm, shortness of breath, diaphoresis. Patient reports feeling faint and nauseous. Secondary symptoms: Anxiety, pale skin. Patient is conscious but distressed. Medical history: Type 2 diabetes, hypertension. Medications: Metformin 1000mg twice daily, Lisinopril 20mg daily, Atorvastatin 40mg daily. No known allergies. Last meal was a light lunch at 12:00.
Timeline: 1415 hours: Patient started experiencing mild chest discomfort 1420 hours: Chest pain increased in severity, radiating to left arm 1422 hours: Patient became short of breath, started sweating 1424 hours: Patient felt faint, called his wife for help 1425 hours: Wife called emergency services 1427 hours: Current time, patient still experiencing severe chest pain, shortness of breath, and diaphoresis Prior Events: Patient had a similar episode 6 months ago, which was diagnosed as angina. Last medical check-up 2 months ago, routine follow-up. Patient is a former smoker (quit 5 years ago). No recent illnesses or injuries.
Initial Impression: Suspected ST-Elevation Myocardial Infarction (STEMI) Justification for F1 Classification: - Classic presentation of acute myocardial infarction with severe chest pain, radiation, diaphoresis, and shortness of breath - High risk of life-threatening arrhythmias and cardiac arrest - Time-critical condition requiring immediate medical intervention Differential Diagnoses: 1. Acute Myocardial Infarction (STEMI - high probability) 2. Unstable Angina (less likely given severity of pain and associated symptoms) 3. Aortic Dissection (less likely, no reported tearing pain) 4. Pulmonary Embolism (less likely, no pleuritic chest pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Immediate notification of hospital cardiac team - Initiation of pre-hospital ECG - Administration of aspirin (if not contraindicated) and oxygen - Preparation for rapid transport to hospital with PCI capabilities