Heiðarvegur 12, 900 Vestmannaeyjar. Two-story residential building, built in 1985, concrete structure. Main entrance is at street level, no elevator, stairs to second floor. Street parking available. No security features beyond standard door lock. Current conditions: 8°C, overcast, light winds, good visibility. GPS coordinates: 63.4415° N, 20.2690° W. Nearest landmark: Vestmannaeyjar Swimming Pool.
65-year-old male, experiencing chest pain. Primary symptoms: Substernal chest pain, described as pressure, radiating to the left arm and jaw, onset 30 minutes ago. Secondary symptoms: Shortness of breath, diaphoresis, nausea. Patient is conscious and alert, but anxious. Medical history: Hypertension, hyperlipidemia, type 2 diabetes. Medications: Metformin 1000mg BID, Atorvastatin 20mg daily, Lisinopril 10mg daily. No known allergies. Last meal was lunch at 13:00.
Timeline: 14:00 hours: Patient began experiencing mild chest discomfort. 14:15 hours: Chest pain intensified, radiating to left arm and jaw. 14:20 hours: Patient experienced shortness of breath and diaphoresis. 14:25 hours: Patient called his wife, who then called emergency services. 14:30 hours: Current time, patient is still experiencing chest pain, shortness of breath, and diaphoresis. Prior Events: Patient reports occasional mild chest discomfort with exertion over the past month, but did not seek medical attention. Patient had a routine check-up 6 months ago, no significant findings reported at that time. Patient has been relatively sedentary for the past few weeks due to inclement weather.
Initial Impression: Suspected Acute Coronary Syndrome - Non-STEMI Justification for F2 Classification: - Presentation consistent with cardiac ischemia, but without clear signs of ST-segment elevation myocardial infarction (STEMI) - Symptoms include substernal chest pain, radiation to left arm and jaw, shortness of breath, and diaphoresis - Risk factors include hypertension, hyperlipidemia, and type 2 diabetes - Time-sensitive condition requiring prompt medical evaluation and treatment Differential Diagnoses: 1. Non-ST-Elevation Myocardial Infarction (NSTEMI) (high probability) 2. Unstable Angina (likely) 3. Aortic Dissection (less likely, no tearing pain) 4. Pulmonary Embolism (less likely, no pleuritic pain) 5. Musculoskeletal Chest Pain (less likely, pain is substernal and radiating) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG monitoring initiation - Oxygen administration - Aspirin administration (if not contraindicated) - Preparation for transport to nearest hospital with cardiac services