Hafnarstræti 23, 600 Akureyri, Ground floor of a two-story commercial building, built in 1955. Main entrance faces the street. No elevator. One main entrance and one back exit. No security features. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6835° N, 18.0921° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing sudden onset chest pain. Primary symptoms: Severe, crushing chest pain radiating to left arm, shortness of breath, diaphoresis. Patient reports feeling nauseous and lightheaded. Secondary symptoms: Anxiety, feeling of impending doom. Patient is conscious and alert but appears distressed. Skin is pale and clammy. Patient sitting on a chair in his office. Medical history: Hypertension, hypercholesterolemia, smoker for 40 years. Medications: Atorvastatin 20mg daily, Lisinopril 10mg daily, Aspirin 75mg daily. No known allergies. Last meal was lunch at 13:00.
Timeline: 14:30 hours: Patient started experiencing mild chest discomfort. 14:40 hours: Chest pain increased in intensity and started radiating to the left arm. 14:45 hours: Patient became short of breath and started sweating profusely. 14:48 hours: Patient called emergency services. 14:50 hours: Current time, patient sitting in office, awaiting help. Prior Events: Patient reports occasional episodes of mild chest discomfort over the past few weeks, but no prior episodes of severe pain. Last medical check-up 6 months ago, routine follow-up. No recent illnesses or injuries. Patient has a stressful job. Patient reports family history of heart disease.
Initial Impression: Suspected Acute Coronary Syndrome (ACS) Justification for F2 Classification: - High probability of life-threatening condition based on symptoms and risk factors - Severe chest pain, radiation to left arm, diaphoresis, shortness of breath - Time-sensitive condition requiring rapid medical intervention to limit myocardial damage Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (likely) 3. Aortic Dissection (less likely, no tearing pain) 4. Pulmonary Embolism (less likely, no pleuritic pain or recent surgery) 5. Esophageal Spasm (less likely, pain is severe and radiating) Required Actions: - Dispatch of ground EMS with ALS capabilities - Administration of oxygen and aspirin (if not already taken) - ECG monitoring and interpretation - Preparation for transport to nearest hospital with cardiac services