Hafnarstræti 18, 600 Akureyri. Second floor office, accessed by stairs or elevator. Three-story commercial building constructed in 1968, renovated in 2005. Main entrance facing Hafnarstræti. One fire escape on the building's rear side. No specific security features. Weather: 7°C, overcast, light wind. GPS: 65.6812° N, 18.0901° W. Nearest landmark: Akureyri Art Museum.
51-year-old male, sudden onset of severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm, shortness of breath, diaphoresis. Secondary symptoms: Nausea, dizziness. Patient is conscious but anxious. Skin is pale and clammy. Patient is sitting in his office chair. Medical history: Hypertension, hypercholesterolemia. Medications: Lisinopril 10mg daily, Atorvastatin 20mg daily. No known allergies. Last meal was lunch at 12:30, a sandwich and yogurt.
Timeline: 1345 hours: Patient began feeling mild chest discomfort. 1350 hours: Chest pain intensified, radiating to the left arm, shortness of breath started. 1352 hours: Patient became diaphoretic, reported nausea and dizziness. 1354 hours: Patient called his colleague for help, colleague called emergency services. 1356 hours: Current time, patient is sitting in his office chair, conscious but distressed. Prior Events: Patient reports intermittent mild chest discomfort over the past week, which he attributed to indigestion. No prior history of heart attack or angina. Last medical check-up was 6 months ago, routine follow-up.
Initial Impression: Suspected Acute Myocardial Infarction (AMI) Justification for F2 Classification: - High probability of cardiac event based on symptoms and risk factors - Severe chest pain, radiating to the left arm, shortness of breath, diaphoresis - Time-sensitive condition requiring prompt medical intervention to minimize myocardial damage Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Angina Pectoris (less likely due to severity and duration of pain) 3. Aortic Dissection (less likely, no reported tearing pain) 4. Pulmonary Embolism (less likely, no history of recent surgery or prolonged immobility) 5. Esophageal Spasm (less likely, pain more severe and associated with diaphoresis) Required Actions: - Dispatch of ground EMS with ALS capabilities - Initiation of cardiac monitoring and oxygen therapy - Administration of aspirin if not contraindicated - Preparation for transport to nearest hospital with cardiac catheterization lab