Hafnarstræti 25, 600 Akureyri, second floor office. Three-story brick building built in 1965, main entrance on street level with a small flight of stairs. No elevator. Street parking available. Building has a fire alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6827° N, 18.0922° W. Nearest landmark: Akureyri Art Museum.
55-year-old male, experiencing severe chest pain. Primary symptoms: Sudden onset of crushing chest pain, radiating to left arm and jaw, shortness of breath, diaphoresis. Secondary symptoms: Nausea, dizziness. Patient is conscious and anxious. Skin pale and clammy. Patient is in his office, sitting in a chair. Medical history: Hypertension, hyperlipidemia. Medications: Lisinopril 20mg daily, Atorvastatin 40mg daily. No known allergies. Last meal was a light lunch at 12:30.
Timeline: 1400 hours: Patient reports feeling well, working at his desk. 1415 hours: Patient reports sudden onset of severe chest pain, began to feel short of breath. 1418 hours: Patient called his colleague for help. 1420 hours: Colleague called emergency services. 1422 hours: Current time, patient still experiencing chest pain, difficulty breathing. Prior Events: Patient reports occasional episodes of mild chest discomfort in the past month, which he attributed to indigestion. No prior heart attacks or surgeries. Last medical check-up 6 months ago, routine follow-up. Patient is a smoker, smokes approximately 10 cigarettes per day.
Initial Impression: Suspected Acute Coronary Syndrome (ACS), possible Myocardial Infarction Justification for F2 Classification: - High probability of a cardiac event based on chest pain characteristics, radiation, and associated symptoms - Time-sensitive condition requiring prompt medical intervention to minimize myocardial damage - Patient is symptomatic and distressed, indicating a potentially unstable situation Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (likely) 3. Aortic Dissection (less likely given no reported back pain) 4. Pulmonary Embolism (less likely given symptoms onset and character) 5. Musculoskeletal Chest Pain (less likely given the severity and radiation of pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Initiation of cardiac monitoring and ECG - Oxygen administration - Preparation for possible need for advanced cardiac life support - Early hospital notification of a potential ACS case