Hafnarstræti 18, 600 Akureyri. Second floor office, accessed by stairs and elevator. Concrete building, constructed in 1990. Main entrance faces Hafnarstræti. No known security features. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6822° N, 18.0895° W. Nearest landmark: Akureyri Art Museum.
55-year-old male, sudden onset of severe chest pain. Primary symptoms: Substernal chest pain described as 'crushing', radiating to the left arm and jaw. Secondary symptoms: Diaphoresis, nausea, shortness of breath. Patient is conscious and anxious. Skin pale and clammy. Patient is sitting upright at his desk. Medical history: Hypertension, hypercholesterolemia. Medications: Lisinopril 20mg daily, Atorvastatin 40mg daily. No known allergies. Last meal was a sandwich at 12:30.
Timeline: 1345 hours: Patient reports sudden onset of chest pain while working at his desk. 1346 hours: Patient experiences increasing chest pain, radiating to the left arm and jaw. Reports shortness of breath and nausea. 1347 hours: Patient calls colleague for help. 1348 hours: Colleague calls emergency services. 1350 hours: Current time, patient is sitting upright, pale, and diaphoretic. No prior incidents of chest pain, but reports feeling unwell for the past few days, attributing it to stress. Last medical check-up 6 months ago, routine follow-up. No recent hospitalizations.
Initial Impression: Suspected Acute Coronary Syndrome (ACS), likely Myocardial Infarction Justification for F2 Classification: - High probability of a life-threatening cardiac event based on classic symptoms - Chest pain, radiating to left arm and jaw, diaphoresis, shortness of breath - Time-sensitive condition requiring prompt medical intervention to minimize cardiac damage Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (likely, requires further evaluation) 3. Aortic Dissection (less likely, but must be considered) 4. Pulmonary Embolism (less likely given presentation) 5. Gastroesophageal Reflux (less likely given severity and radiation of pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG acquisition and interpretation - Administration of aspirin and oxygen - Preparation for rapid transport to nearest hospital with cardiac catheterization lab