Hafnarstræti 23, 600 Akureyri. Ground floor of a two-story commercial building, built in 1955, concrete structure with large display windows. Main entrance at street level, no security features. Street parking available. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6822° N, 18.0892° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm, shortness of breath, diaphoresis, nausea. Secondary symptoms: Dizziness, anxiety. Patient is pale and distressed. Patient is conscious and able to speak. Patient is sitting on a chair in the back office of his shop. Medical history: Hypertension, hyperlipidemia, type 2 diabetes. Medications: Metformin 1000mg BID, Atorvastatin 20mg daily, Lisinopril 10mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1430 hours: Patient started experiencing mild chest discomfort while working 1440 hours: Chest pain intensified, radiating to left arm, accompanied by shortness of breath and sweating 1445 hours: Patient sat down, feeling dizzy and nauseous 1448 hours: Patient asked his employee to call emergency services 1450 hours: Current time, patient is sitting in a chair, pale, distressed, experiencing severe chest pain Prior Events: Patient reports occasional mild chest discomfort in the past, attributed to indigestion. Last medical check-up was 6 months ago, routine follow-up. No recent illnesses or injuries. Patient has a family history of heart disease.
Initial Impression: Suspected Acute Myocardial Infarction (AMI) Justification for F2 Classification: - Classic symptoms of AMI: severe chest pain, radiation, diaphoresis, shortness of breath - High risk factors: age, hypertension, hyperlipidemia, diabetes - Time-sensitive condition requiring prompt medical intervention to minimize cardiac damage Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Angina Pectoris (less likely given severity and onset) 3. Aortic Dissection (less likely given no tearing pain) 4. Pulmonary Embolism (less likely given lack of pleuritic pain) 5. Musculoskeletal chest pain (less likely given severity and associated symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - Immediate ECG monitoring and interpretation - Oxygen administration - Preparation for possible administration of aspirin and nitroglycerin - Transport to nearest hospital with cardiac catheterization lab