Hafnarstræti 19, 600 Akureyri, ground floor of a commercial building. Building is a 2-story concrete structure built in 1965, main entrance has a single glass door, no elevator, secondary entrance at the rear with a metal door, street parking available, no security features, current weather: 8°C, overcast, light breeze, good visibility. GPS coordinates: 65.6817° N, 18.0923° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe chest pain. Primary symptoms: crushing chest pain radiating to the left arm, shortness of breath, diaphoresis. Secondary symptoms: nausea, dizziness. Patient is conscious but anxious. Skin is pale and clammy. Patient is sitting in a chair in his office. Medical history: Hypertension, hypercholesterolemia, type 2 diabetes. Medications: Metformin 1000mg twice daily, Atorvastatin 20mg daily, Lisinopril 20mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1445 hours: Patient reports onset of chest pain while working at his desk 1447 hours: Patient attempts to alleviate pain with rest, no relief 1450 hours: Pain intensifies, shortness of breath develops 1452 hours: Patient calls his son for help 1455 hours: Son arrives and calls emergency services 1458 hours: Current time, patient still experiencing severe chest pain Prior Events: Patient has had episodes of mild chest discomfort in the past, attributed to indigestion. No recent hospitalizations or surgeries. Last medical check-up 6 months ago, routine follow-up. Patient lives alone, son lives nearby.
Initial Impression: Suspected Acute Coronary Syndrome (ACS) Justification for F2 Classification: - High probability of a serious cardiac event based on symptoms and risk factors - Chest pain, radiating to the arm, shortness of breath, diaphoresis - Time-sensitive condition requiring prompt medical intervention to minimize cardiac damage Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (likely) 3. Aortic Dissection (less likely given presentation) 4. Pulmonary Embolism (less likely given presentation) 5. Musculoskeletal Chest Pain (less likely given severity of symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Aspirin administration - 12-lead ECG acquisition - Preparation for transport to nearest hospital with cardiac catheterization capabilities