Miðgarður 15, 700 Egilsstaðir, ground floor apartment 1B. Three-story concrete residential building constructed in 1985. Main entrance requires key or intercom. One central stairwell, no elevator. Street parking available. Building equipped with fire alarm system. Current conditions: 8°C, overcast, moderate visibility. GPS coordinates: 65.2686° N, 14.3949° W. Nearest landmark: Egilsstaðir swimming pool.
65-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain, radiating to the left arm and jaw, shortness of breath, diaphoresis. Secondary symptoms: Nausea, dizziness. Patient is conscious but appears distressed. Skin pale and clammy. Patient is sitting on a chair in his living room. Medical history: Hypertension, hyperlipidemia. Medications: Amlodipine 10mg daily, Atorvastatin 20mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1410 hours: Patient reports onset of sudden, severe chest pain. 1412 hours: Pain intensifies, radiating to left arm and jaw. Patient becomes short of breath and diaphoretic. 1413 hours: Patient attempts to take antacid with no relief. 1414 hours: Patient calls wife, who then calls emergency services. 1415 hours: Current time, patient still experiencing severe chest pain, wife is with him. Prior Events: Patient has had occasional mild chest discomfort over the past few weeks, but attributed it to indigestion. Last medical check-up 6 months ago, routine follow-up. No recent illnesses or injuries. Patient is a former smoker, quit 10 years ago. Family history of heart disease.
Initial Impression: Suspected Acute ST-Elevation Myocardial Infarction (STEMI) Justification for F1 Classification: - Classic presentation of STEMI: severe crushing chest pain, radiation, diaphoresis, shortness of breath - Time-sensitive condition requiring immediate intervention to minimize myocardial damage - High risk of cardiac arrest and death without prompt treatment Differential Diagnoses: 1. Acute STEMI (high probability) 2. Unstable Angina (less likely given severity and duration of symptoms) 3. Aortic Dissection (less likely given lack of tearing pain) 4. Pulmonary Embolism (less likely given lack of pleuritic pain and risk factors) Required Actions: - Immediate dispatch of ground EMS with ALS capabilities - Pre-arrival instructions for patient positioning and potential aspirin administration - Early notification of receiving hospital for activation of cardiac catheterization lab - Continuous monitoring and preparation for potential cardiac arrest