Heiðarvegur 18, 900 Vestmannaeyjar. Two-story residential building, built in 1985. Main entrance with key access. Stairwell only, no elevator. Street parking available. Building has a basic smoke alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 63.4403° N, 20.2715° W. Nearest landmark: Vestmannaeyjar Hospital.
51-year-old male, severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm, shortness of breath, diaphoresis. Secondary symptoms: Nausea, lightheadedness. Patient is pale, anxious. Patient is sitting upright on a chair in his living room. Medical history: Hypertension, hyperlipidemia, family history of heart disease. Medications: Amlodipine 10mg daily, Atorvastatin 20mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1430 hours: Patient experienced sudden onset of severe chest pain while watching TV. 1432 hours: Pain intensified, radiating to left arm, patient became short of breath and diaphoretic. 1434 hours: Patient attempted to take antacids, no relief. 1435 hours: Patient called emergency services. 1436 hours: Current time, patient still experiencing severe chest pain. Prior Events: Patient had a routine checkup 6 months ago, blood pressure slightly elevated. No recent illnesses or injuries. Patient reports occasional mild chest discomfort over the past few months, but never this severe. Patient is a smoker, 1 pack per day for 30 years.
Initial Impression: Suspected ST-Elevation Myocardial Infarction (STEMI) Justification for F1 Classification: - High probability of acute myocardial infarction based on classic symptoms (crushing chest pain, radiation to left arm, shortness of breath, diaphoresis). - Time-critical condition requiring immediate intervention to limit myocardial damage. - Symptoms consistent with acute coronary syndrome. - Patient has risk factors for cardiac disease. Differential Diagnoses: 1. STEMI (high probability) 2. Unstable Angina (less likely given severity and radiation of pain) 3. Aortic Dissection (less likely, no tearing pain reported) 4. Pulmonary Embolism (less likely, no recent surgery or prolonged immobilization) 5. Pericarditis (less likely, pain is not positional) Required Actions: - Dispatch of ground EMS with ALS capabilities. - Immediate notification of hospital for cardiac alert activation. - Pre-hospital ECG acquisition and interpretation. - Administration of aspirin if no contraindications. - Oxygen administration if SpO2 is below 94%.