Hafnarstræti 91, 600 Akureyri, third floor apartment 3B. A three-story concrete building constructed in 1968. Main entrance is accessible via a coded lock (code: 1478). No elevator, access via a central stairwell. Street parking available. Building is equipped with a basic fire alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6817° N, 18.0922° W. Nearest landmark: Akureyri Art Museum.
61-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to the left arm and jaw, shortness of breath, diaphoresis. Secondary symptoms: Nausea, dizziness. Patient is pale and anxious. Patient is conscious but distressed. Medical history: Hypertension, hyperlipidemia, type 2 diabetes. Medications: Metformin 1000mg BID, Atorvastatin 40mg daily, Lisinopril 20mg daily, Aspirin 81mg daily. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1410 hours: Patient began experiencing chest discomfort while watching TV 1415 hours: Pain intensified, radiating to left arm and jaw, accompanied by shortness of breath 1418 hours: Patient became diaphoretic and nauseous 1420 hours: Patient called his son, who is now calling emergency services 1422 hours: Current time, patient is still experiencing severe chest pain and distress Prior Events: Patient has a history of hypertension, hyperlipidemia, and type 2 diabetes. He had a routine check-up 6 months ago, which showed no significant changes. He has been experiencing mild intermittent chest discomfort for the past few weeks, but attributed it to indigestion. He has no prior history of heart attack or stroke. No recent illnesses or injuries. He lives with his wife.
Initial Impression: Suspected ST-Elevation Myocardial Infarction (STEMI) Justification for F1 Classification: - Classic presentation of acute myocardial infarction with severe chest pain, radiation, diaphoresis, and shortness of breath - Time-critical condition requiring immediate intervention to prevent irreversible myocardial damage - High risk of cardiac arrest or other life-threatening complications Differential Diagnoses: 1. STEMI (high probability) 2. Unstable Angina (less likely given severity and radiation of pain) 3. Aortic Dissection (less likely, no reported tearing pain) 4. Pulmonary Embolism (less likely, no specific risk factors) 5. Pericarditis (less likely, no pleuritic pain) Required Actions: - Immediate dispatch of ground EMS with ALS capabilities - Pre-hospital ECG acquisition and transmission - Notification of receiving hospital for potential PCI activation - Administration of oxygen, aspirin, and other appropriate medications - Preparation for potential cardiac arrest