Heimagata 7, 900 Vestmannaeyjar, first floor apartment. Two-story wooden residential building built in 1955. Main entrance is accessible via a small ramp. No elevator. Street parking available. Building equipped with smoke detectors. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 63.4406° N, 20.2723° W. Nearest landmark: Vestmannaeyjar Hospital.
65-year-old male, experiencing chest pain. Primary symptoms: Substernal chest pain described as pressure, radiating to the left arm and jaw, shortness of breath, nausea. Patient is pale and diaphoretic. Secondary symptoms: Anxiety, feeling of impending doom. Patient is conscious and responsive. Medical history: Hypertension, hyperlipidemia, previous smoking history (quit 5 years ago). Medications: Amlodipine 10mg daily, Atorvastatin 20mg daily, Aspirin 75mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 14:00 hours: Patient started experiencing mild chest discomfort while watching television. 14:15 hours: Chest pain intensified, radiating to left arm and jaw, accompanied by shortness of breath. 14:20 hours: Patient started feeling nauseous and diaphoretic. 14:25 hours: Patient called his wife for help. 14:28 hours: Wife called emergency services. 14:30 hours: Current time, patient is sitting on a chair, pale and distressed. Prior Events: Patient reports occasional mild chest discomfort with exertion in the past few months. No prior hospitalizations for cardiac issues. Last check-up 6 months ago, routine follow-up with primary care physician. Patient lives with his wife, who is present.
Initial Impression: Suspected Acute Coronary Syndrome (Non-STEMI) Justification for F2 Classification: - High probability of cardiac event based on chest pain characteristics, radiation, and associated symptoms - Time-sensitive condition requiring prompt medical evaluation and treatment - Patient is symptomatic and distressed, with risk of deterioration Differential Diagnoses: 1. Non-ST Elevation Myocardial Infarction (NSTEMI) (high probability) 2. Unstable Angina (likely differential) 3. Aortic Dissection (less likely, but must be considered) 4. Pulmonary Embolism (less likely, but must be considered) 5. Gastroesophageal Reflux (less likely given severity and radiation of pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and cardiac monitoring - Administration of aspirin (if not already taken) - Preparation for transport to nearest hospital with cardiac catheterization lab