Heiðarvegur 14, 900 Vestmannaeyjar, Ground floor apartment. Two-story wooden residential building constructed in 1965. Main entrance is at street level. No elevator. Street parking available. Building equipped with basic smoke detectors. Current conditions: 8°C, overcast, moderate visibility. GPS coordinates: 63.4409° N, 20.2730° W. Nearest landmark: Vestmannaeyjar Hospital.
65-year-old male, experiencing chest pain. Primary symptoms: Central chest pain described as pressure, radiating to left arm and jaw. Secondary symptoms: Shortness of breath, nausea, diaphoresis. Patient is conscious and anxious. Medical history: Hypertension, hypercholesterolemia, type 2 diabetes. Medications: Metformin 1000mg twice daily, Atorvastatin 20mg daily, Lisinopril 10mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1430 hours: Patient began experiencing mild chest discomfort 1445 hours: Chest pain intensified, radiating to left arm and jaw, accompanied by shortness of breath and sweating 1450 hours: Patient called his son, Jón, for help 1455 hours: Jón arrived and called emergency services 1457 hours: Current time, patient sitting on a chair, pale and diaphoretic Prior Events: Patient reports experiencing similar but milder episodes of chest discomfort in the past few months, which he attributed to indigestion. No recent hospitalizations. Last medical check-up was 6 months ago, routine follow-up. Patient lives alone, 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 (chest pain, radiation, shortness of breath) - Patient has multiple risk factors for coronary artery disease (hypertension, hypercholesterolemia, diabetes) - Time-sensitive condition requiring prompt medical evaluation and intervention Differential Diagnoses: 1. NSTEMI (high probability) 2. Unstable Angina (high probability) 3. Aortic Dissection (lower probability, no reported tearing pain) 4. Pulmonary Embolism (lower probability, no sudden onset of severe dyspnea) 5. Musculoskeletal Chest Pain (less likely given the radiating pain and associated symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration if SpO2 < 94% - Aspirin administration (if no contraindications) - ECG monitoring and interpretation - Preparation for transport to nearest hospital with cardiac services