Heimagata 7, 900 Vestmannaeyjar, ground floor apartment 1B. Two-story wooden residential building constructed in 1965. Main entrance has a small step. No elevator. Street parking available. Building has a basic fire alarm system. Current conditions: 8°C, overcast, moderate visibility. GPS coordinates: 63.4405° N, 20.2753° W. Nearest landmark: Vestmannaeyjar Hospital.
65-year-old male, experiencing chest pain. Primary symptoms: Severe, crushing chest pain radiating to left arm, shortness of breath, nausea, diaphoresis. Patient reports feeling 'extremely unwell'. Secondary symptoms: Lightheadedness. Patient is alert but anxious. Skin pale and clammy. Patient is sitting on a chair in the living room. Medical history: Hypertension, hyperlipidemia, type 2 diabetes. Medications: Metformin 1000mg twice daily, Atorvastatin 20mg daily, Lisinopril 10mg daily, Aspirin 75mg daily. No known allergies. Last meal was a light lunch at 12:00.
Timeline: 1410 hours: Patient began experiencing mild chest discomfort. 1415 hours: Chest pain increased in intensity, radiating to left arm. Shortness of breath began. 1420 hours: Patient felt nauseous and began sweating. Became lightheaded. 1425 hours: Patient called his wife for help. 1428 hours: Wife arrived, called emergency services. 1430 hours: Current time, patient still sitting, experiencing severe chest pain. Prior Events: Patient reports occasional episodes of chest discomfort with exertion in the past year, but never this severe. Last medical check-up 6 months ago, routine follow-up. No recent illnesses or injuries. Patient lives with his wife.
Initial Impression: Suspected Acute Coronary Syndrome (Non-STEMI) Justification for F2 Classification: - High probability of cardiac event based on classic symptoms (chest pain, radiation, diaphoresis, nausea) - Patient is stable but symptomatic, requiring urgent medical assessment and treatment - Time-sensitive condition, but not immediately life-threatening like a STEMI Differential Diagnoses: 1. Non-ST-Elevation Myocardial Infarction (NSTEMI) (high probability) 2. Unstable Angina (likely) 3. Aortic Dissection (less likely given presentation) 4. Pericarditis (less likely given pain characteristics) 5. Pulmonary Embolism (less likely given primary symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG monitoring and acquisition - Oxygen administration - Aspirin administration (if not already taken) - Preparation for transport to nearest hospital with cardiac services