Hlíðarvegur 7, 400 Ísafjörður, single-family home, built in 1985. One-story wooden structure with a small porch. Main entrance facing the street, no security features. Gravel driveway. Current conditions: 3°C, light snow, moderate visibility. GPS coordinates: 66.0753° N, 23.1268° W. Nearest landmark: Ísafjörður Hospital.
68-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to the left arm and jaw, shortness of breath, diaphoresis. Patient reports feeling 'like an elephant is sitting on my chest'. Secondary symptoms: Nausea, dizziness. Patient is pale and anxious. Medical history: Hypertension, hyperlipidemia, previous MI 5 years ago. Medications: Aspirin 75mg daily, Atorvastatin 20mg daily, Lisinopril 10mg daily, Metoprolol 50mg twice daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1415 hours: Patient started experiencing mild chest discomfort 1420 hours: Chest pain increased in severity, radiating to left arm and jaw 1422 hours: Patient became diaphoretic, short of breath, and nauseous 1424 hours: Patient called emergency services 1426 hours: Current time, patient still experiencing severe chest pain Prior Events: Patient has a history of previous myocardial infarction (MI) 5 years ago, treated with percutaneous coronary intervention (PCI). Patient has been compliant with medications and regular follow-ups. No recent illnesses or injuries. Last medical check-up 6 months ago, routine follow-up. Patient lives with his wife, who is currently with him.
Initial Impression: Suspected ST-Elevation Myocardial Infarction (STEMI) Justification for F1 Classification: - Severe, crushing chest pain with radiation, diaphoresis, and shortness of breath - Patient's history of previous MI and risk factors for coronary artery disease - Time-critical condition requiring immediate intervention to prevent irreversible myocardial damage Differential Diagnoses: 1. STEMI (high probability) 2. Unstable Angina (less likely given severity and duration of symptoms) 3. Aortic Dissection (less likely, no tearing pain) 4. Pulmonary Embolism (less likely, no pleuritic pain or hemoptysis) Required Actions: - Immediate dispatch of ground EMS with ALS capabilities - Pre-hospital 12-lead ECG acquisition and transmission - Early hospital notification with STEMI alert activation - Preparation for potential thrombolysis or PCI