Miðgarður 11, 700 Egilsstaðir, single-story detached house built in 1985. Main entrance via front door, no steps. Paved driveway, ample parking. No security features. Current conditions: 8°C, clear skies, good visibility. GPS coordinates: 65.2667° N, 14.3994° W. Nearest landmark: Egilsstaðir Airport.
65-year-old male, experiencing severe chest pain. Primary symptoms: crushing chest pain radiating to left arm and jaw, shortness of breath, diaphoresis. Secondary symptoms: nausea, dizziness. Patient is pale and anxious. Patient is sitting on a chair in the living room. Medical history: Type 2 diabetes, hypertension, previous angioplasty 5 years ago. Medications: Metformin 1000mg twice daily, Lisinopril 20mg daily, Aspirin 75mg daily, Atorvastatin 40mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1415 hours: Patient experienced sudden onset of severe chest pain while watching TV 1416 hours: Pain intensified, radiating to left arm and jaw, associated with shortness of breath and sweating 1417 hours: Patient felt nauseous and dizzy 1418 hours: Patient called emergency services 1420 hours: Current time, patient still experiencing severe chest pain, pale and anxious Prior Events: Patient had angioplasty for a previous heart attack 5 years ago, has been compliant with medications. No recent illnesses or injuries. Last medical check-up 6 months ago, routine follow-up. Patient lives with his wife.
Initial Impression: Suspected ST-Elevation Myocardial Infarction (STEMI) Justification for F1 Classification: - High probability of acute myocardial infarction based on classic symptoms: severe crushing chest pain, radiation to left arm and jaw, diaphoresis, shortness of breath - Time-critical condition requiring immediate intervention to limit myocardial damage - Patient's history of previous angioplasty increases risk of acute coronary syndrome Differential Diagnoses: 1. STEMI (high probability) 2. Unstable Angina (less likely given severity of pain and associated symptoms) 3. Aortic Dissection (less likely given lack of tearing pain and unequal pulses) 4. Pulmonary Embolism (less likely given absence of pleuritic pain and hemoptysis) Required Actions: - Immediate dispatch of ground EMS with ALS capabilities - Pre-arrival instructions for aspirin administration if not already taken - Early notification of receiving hospital with cardiac catheterization lab - Prepare for possible cardiac arrest