Hafnarbraut 12, 780 Höfn í Hornafirði. Ground floor apartment in a two-story concrete building constructed in 1985. Main entrance is at ground level, no stairs. No elevator. Street parking available. Building equipped with basic fire alarm system. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 64.2527° N, 15.2085° W. Nearest landmark: Höfn Harbour.
65-year-old male, experiencing chest pain. Primary symptoms: Severe, crushing chest pain radiating to left arm and jaw, shortness of breath, diaphoresis. Patient reports feeling very anxious. Secondary symptoms: Nausea, dizziness. Patient alert but distressed. Skin pale and clammy. Patient is sitting on the sofa in his living room. Medical history: Hypertension, hypercholesterolemia, type 2 diabetes. Medications: Metformin 500mg twice daily, Atorvastatin 20mg daily, Lisinopril 10mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1430 hours: Patient experienced sudden onset of chest pain while watching TV. 1432 hours: Patient reports pain worsening, radiating to arm and jaw, feeling very short of breath. 1435 hours: Patient called his son for help. 1438 hours: Son arrived, called emergency services. 1440 hours: Current time, patient still sitting on sofa, in distress. Prior Events: Patient has a history of hypertension, hypercholesterolemia and type 2 diabetes. Has had occasional episodes of mild chest discomfort in the past, but nothing this severe. Last medical check-up 6 months ago, routine follow-up. Patient lives alone, but son lives nearby.
Initial Impression: Suspected Acute Coronary Syndrome - Non-ST Elevation Myocardial Infarction (NSTEMI) Justification for F2 Classification: - High probability of acute cardiac event based on symptoms (severe chest pain, radiation, diaphoresis) - Patient has risk factors (hypertension, hypercholesterolemia, diabetes) - Time-sensitive condition requiring prompt medical evaluation and intervention Differential Diagnoses: 1. NSTEMI (high probability) 2. Unstable Angina (likely given symptoms, less severe than STEMI) 3. Aortic Dissection (less likely given absence of tearing pain) 4. Pulmonary Embolism (less likely, no history of recent travel or immobilization) 5. Musculoskeletal chest pain (less likely given severity and radiation of pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG monitoring - Oxygen administration - Aspirin administration - Preparation for transport to nearest hospital with cardiac services