Miðgarður 14, 700 Egilsstaðir, first floor apartment 103. A three-story residential building built in 1995. Main entrance is accessible via ramp and stairs. Building has a central stairwell and an elevator. Street parking available. Building has a basic fire alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.2658° N, 14.3938° W. Nearest landmark: Egilsstaðir Airport.
52-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm and jaw, shortness of breath, diaphoresis. Patient reports sudden onset of pain. Secondary symptoms: Nausea, lightheadedness. Patient is conscious but distressed. Skin pale and clammy. Patient is sitting on a chair in the living room. Medical history: Hypertension, hyperlipidemia, family history of heart disease. Medications: Atorvastatin 20mg daily, Lisinopril 10mg daily, Aspirin 75mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 14:10 hours: Patient started experiencing mild chest discomfort 14:15 hours: Chest pain increased in intensity, radiating to left arm and jaw 14:17 hours: Patient became diaphoretic and short of breath 14:19 hours: Patient called emergency services 14:20 hours: Current time, patient still experiencing severe chest pain Prior Events: Patient reports occasional chest discomfort in the past year, no prior cardiac events. Last medical check-up 6 months ago, routine follow-up. Patient is a smoker. No recent illnesses or injuries. Patient was resting at home when symptoms began.
Initial Impression: Suspected Acute ST-Elevation Myocardial Infarction (STEMI) Justification for F1 Classification: - Classic presentation of STEMI, including severe crushing chest pain, radiation, diaphoresis, and shortness of breath - High risk of life-threatening complications (arrhythmias, cardiac arrest) - Time-critical condition requiring immediate intervention to restore coronary blood flow Differential Diagnoses: 1. Acute Coronary Syndrome (ACS), STEMI (high probability) 2. Acute Coronary Syndrome (ACS), NSTEMI (less likely given symptom severity) 3. Aortic Dissection (less likely given lack of tearing pain) 4. Pulmonary Embolism (less likely given absence of pleuritic pain) 5. Pericarditis (less likely given lack of positional pain) Required Actions: - Immediate dispatch of ground EMS with ALS capabilities - Early notification of receiving hospital with PCI capabilities - Pre-hospital ECG transmission if possible - Oxygen administration and IV access establishment - Aspirin and antiplatelet administration if not contraindicated