Hafnarstræti 23, 600 Akureyri, ground floor, retail shop 'Bókabúðin'. One-story building constructed in 1965, large glass storefront facing the street. Main entrance at street level, no stairs. No security system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6821° N, 18.0915° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing sudden onset of severe chest pain. Primary symptoms: Crushing chest pain radiating to the left arm and jaw, shortness of breath, diaphoresis. Patient reports feeling lightheaded and anxious. Patient is conscious and able to speak in short sentences. Medical history: Hypertension, hypercholesterolemia, previous MI 5 years ago. Medications: Aspirin 75mg daily, Atorvastatin 20mg daily, Ramipril 5mg daily. Known allergy to penicillin. Last meal was a sandwich at 12:00.
Timeline: 1315 hours: Patient started experiencing chest pain while working in his shop 1317 hours: Patient's pain intensified, developed shortness of breath 1318 hours: Patient sat down, called his son for help 1320 hours: Son arrived, called emergency services 1322 hours: Current time, patient still experiencing severe chest pain, pale and diaphoretic Prior Events: Patient reports feeling well earlier today. No recent illnesses or injuries. Last medical check-up 6 months ago, routine follow-up. Patient is a smoker, approximately 1 pack per day. No recent changes in medication.
Initial Impression: Suspected Acute Coronary Syndrome (ACS), likely Myocardial Infarction (MI) Justification for F2 Classification: - High probability of cardiac event based on classic symptoms: chest pain, radiation, shortness of breath, diaphoresis - Patient's history of previous MI and risk factors increase suspicion - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Myocardial Infarction (high probability) 2. Unstable Angina (likely, requires evaluation) 3. Aortic Dissection (less likely, no tearing pain) 4. Pulmonary Embolism (less likely, no recent surgery or immobilization) Required Actions: - Dispatch of ground EMS with ALS capabilities - Immediate ECG acquisition and interpretation - Aspirin administration if not already taken - Oxygen therapy if saturation is low - Preparation for transport to nearest hospital with cardiac catheterization capabilities