Hafnarstræti 19, 600 Akureyri, ground floor retail space. Single-story commercial building, concrete construction, built in 1960. Main entrance at street level, large glass windows. No stairs. Street parking available. Building equipped with basic fire extinguishers. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6818° N, 18.0898° 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 sudden onset of symptoms while working in his shop. Secondary symptoms: Nausea, dizziness. Patient is conscious but anxious. Skin is pale and clammy. Patient is sitting on a chair in the back office of his shop. Medical history: Hypertension, hypercholesterolemia. Medications: Lisinopril 20mg daily, Atorvastatin 40mg daily, Aspirin 75mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1410 hours: Patient reports sudden onset of severe chest pain while lifting a box. 1411 hours: Patient sits down, reports shortness of breath and pain radiating to left arm and jaw. 1412 hours: Patient becomes diaphoretic and nauseous. 1413 hours: Patient calls his son for help, who then calls emergency services. 1415 hours: Current time, patient is still sitting in chair, experiencing severe chest pain. Prior Events: Patient reports occasional mild chest discomfort in the past, attributed to indigestion. Last medical check-up 6 months ago, routine follow-up. No recent illnesses or injuries. Patient is a smoker (20 cigarettes per day).
Initial Impression: Suspected Acute Coronary Syndrome (ACS), likely Myocardial Infarction Justification for F2 Classification: - High probability of a life-threatening cardiac event based on chest pain characteristics, radiation, and associated symptoms - Patient has risk factors for ACS (hypertension, hypercholesterolemia, smoking) - Time-sensitive condition requiring rapid assessment and intervention Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (less likely, but needs evaluation) 3. Aortic Dissection (less likely, no tearing pain reported) 4. Pulmonary Embolism (less likely, no recent immobilization or surgery) 5. Esophageal Spasm (less likely given severity and radiation of pain) Required Actions: - Immediate dispatch of ground EMS with ALS capabilities - ECG monitoring and interpretation - Administration of oxygen and aspirin if not already taken - Establishment of IV access - Preparation for transport to nearest hospital with cardiac services