Hafnarbraut 10, 780 Höfn, ground floor apartment. Two-story wooden residential building constructed in 1965. Main entrance is at street level, no stairs. No elevator. Street parking available. Building has basic fire safety equipment. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 64.2506° N, 15.2083° W. Nearest landmark: Höfn Harbour.
65-year-old male, experiencing chest pain. Primary symptoms: Central chest pain described as pressure, radiating to left arm and jaw. Secondary symptoms: Diaphoresis, nausea, shortness of breath. Patient is alert and anxious. Medical history: Hypertension, hyperlipidemia, type 2 diabetes. Medications: Metformin 500mg twice daily, Atorvastatin 20mg daily, Lisinopril 10mg daily. Allergies: None known. Last meal was lunch at 13:00.
Timeline: 14:30 hours: Patient started experiencing chest discomfort while resting at home. 14:45 hours: Chest pain increased in intensity, radiating to left arm and jaw. Associated with sweating and nausea. 14:50 hours: Patient took a nitroglycerin tablet sublingually with no relief. 14:55 hours: Patient called emergency services. 15:00 hours: Current time, patient still experiencing chest pain, nausea, and shortness of breath. Prior Events: Patient reports similar episodes of mild chest discomfort over the past month, but this episode is the most severe. No recent hospitalizations. Last medical check-up 6 months ago, routine follow-up. Patient is a retired fisherman and lives with his wife.
Initial Impression: Suspected Acute Coronary Syndrome (Non-STEMI) Justification for F2 Classification: - Classic symptoms of ACS: central chest pain, radiation, diaphoresis, nausea - Time-sensitive condition requiring prompt medical evaluation and intervention - Patient has risk factors for cardiovascular disease (hypertension, hyperlipidemia, diabetes) - Unrelieved chest pain after nitroglycerin suggests ongoing ischemia Differential Diagnoses: 1. Non-ST-Elevation Myocardial Infarction (NSTEMI) (high probability) 2. Unstable Angina (high probability) 3. Stable Angina (less likely given severity and new onset) 4. Aortic Dissection (less likely, no tearing pain) 5. Pulmonary Embolism (less likely, no pleuritic pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and cardiac monitoring - Aspirin administration if not contraindicated - Preparation for transport to nearest hospital with cardiac services