Hafnarstræti 20, 600 Akureyri, first floor of a two-story commercial building. The building is a mixed-use structure with shops on the ground floor and offices above. Constructed in 1965, it is made of concrete with large glass storefronts. Main entrance is on Hafnarstræti, no security features, street parking available. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6838° N, 18.0911° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm and jaw, shortness of breath, diaphoresis. Patient reports feeling very anxious and lightheaded. Secondary symptoms: Nausea. Patient is conscious but distressed. Skin is pale and clammy. Patient sitting on a chair in his office. 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 sandwich at 12:00.
Timeline: 1330 hours: Patient reports onset of chest pain, initially mild, gradually increasing in severity. 1335 hours: Patient experiences shortness of breath and diaphoresis. 1337 hours: Patient called his colleague for help. 1340 hours: Colleague called emergency services. 1342 hours: Current time, patient is still in his office, experiencing severe chest pain. Prior Events: Patient reports occasional mild chest discomfort in the past few months, attributed to indigestion. Last medical check-up was 6 months ago, routine follow-up. No recent illnesses or injuries. Patient has a family history of heart disease.
Initial Impression: Suspected Acute Coronary Syndrome (ACS) - Myocardial Infarction Justification for F2 Classification: - High probability of a cardiac event based on symptom presentation and medical history - Severe chest pain, radiation, shortness of breath, diaphoresis - Time-sensitive condition requiring prompt medical evaluation and intervention Differential Diagnoses: 1. Myocardial Infarction (high probability) 2. Unstable Angina (likely given symptoms) 3. Aortic Dissection (less likely but must be considered) 4. Pulmonary Embolism (less likely given symptoms) 5. Musculoskeletal Chest Pain (less likely given severity and radiation) Required Actions: - Dispatch of ground EMS with ALS capabilities - Cardiac monitoring and ECG acquisition - Oxygen administration - Aspirin administration (if not contraindicated) - Preparation for transport to nearest hospital with cardiac catheterization lab