Hafnarstræti 18, 600 Akureyri, ground floor retail space, former bookstore. One-story brick building, constructed in 1955, renovated in 2010. Main entrance on Hafnarstræti, secondary rear entrance from parking lot. No security features. Street parking available. Current conditions: 7°C, overcast, moderate wind. GPS coordinates: 65.6813° N, 18.0917° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe chest pain. Primary symptoms: Sudden onset of crushing chest pain, radiating to the left arm and jaw. Secondary symptoms: Shortness of breath, diaphoresis, nausea. Patient is conscious but anxious. Skin is pale and clammy. Patient is sitting on a chair in the retail space. Medical history: Hypertension, hypercholesterolemia, type 2 diabetes. Medications: Metformin 500mg twice daily, Atorvastatin 20mg daily, Lisinopril 10mg daily, Aspirin 75mg daily. Known allergy: Penicillin. Last meal was lunch at 13:00, consisting of a sandwich and coffee.
Timeline: 1445 hours: Patient started experiencing chest discomfort, initially mild 1450 hours: Chest pain intensified, radiating to left arm and jaw 1452 hours: Patient became diaphoretic and short of breath 1454 hours: Patient called his son, who then called emergency services 1456 hours: Current time, patient is still experiencing severe chest pain, sitting on a chair. Prior Events: Patient has had no prior cardiac events. Last medical check-up was 6 months ago, routine follow-up. Patient reports occasional mild chest discomfort with exertion, which he attributed to indigestion. Patient is a smoker, approximately 10 cigarettes per day.
Initial Impression: Suspected Acute Myocardial Infarction (AMI) Justification for F2 Classification: - High probability of cardiac event based on classic symptoms: crushing chest pain, radiation, diaphoresis - Patient's medical history includes risk factors: hypertension, hypercholesterolemia, diabetes, smoking - Time-sensitive condition requiring rapid assessment and treatment Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Angina Pectoris (less likely due to severity and sudden onset) 3. Aortic Dissection (lower probability, no tearing pain) 4. Pulmonary Embolism (less likely, no pleuritic pain) 5. Gastroesophageal Reflux Disease (less likely given severity and associated symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG monitoring and interpretation - Oxygen administration - Aspirin administration (if not already taken) - Preparation for transport to nearest hospital with cardiac catheterization capabilities