Hafnarstræti 23, 600 Akureyri. Ground floor of a two-story commercial building, built in 1965. Main entrance facing Hafnarstræti. Secondary entrance at the back, accessible via a narrow alleyway. No elevator, stairs only to the second floor. Street parking available. Building has basic fire safety measures. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6823° N, 18.0888° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm and jaw, shortness of breath, diaphoresis. Patient is pale, anxious, and reports feeling lightheaded. Secondary symptoms: Nausea. Patient is conscious and able to speak, but appears distressed. Patient sitting on a chair in his office. Medical history: Hypertension, hypercholesterolemia, type 2 diabetes. Medications: Metformin 1000mg twice daily, Atorvastatin 20mg daily, Lisinopril 20mg daily. Allergies: None known. Last meal: Light lunch at 13:00.
Timeline: 1445 hours: Patient reports sudden onset of chest pain while working at his desk. 1446 hours: Pain intensifies, radiates to left arm and jaw. Patient becomes diaphoretic and short of breath. 1447 hours: Patient attempts to take deep breaths, but pain worsens. He feels nauseous. 1448 hours: Patient calls his son for assistance, who then calls emergency services. 1450 hours: Current time, patient still experiencing severe chest pain, sitting in his chair. Prior Events: Patient has a history of hypertension, hypercholesterolemia, and type 2 diabetes. He reports occasional mild chest discomfort over the past few months, which he attributed to indigestion. Last medical check-up 6 months ago, routine follow-up. No recent illnesses or injuries.
Initial Impression: Suspected Acute Coronary Syndrome (ACS), likely Myocardial Infarction (MI) Justification for F2 Classification: - Severe chest pain with radiation, diaphoresis, and shortness of breath strongly suggestive of ACS. - Patient has multiple risk factors for cardiovascular disease. - Time-sensitive condition requiring prompt medical evaluation and intervention to minimize myocardial damage. Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (less likely given severity and duration of symptoms) 3. Aortic Dissection (less likely, no tearing pain reported) 4. Pulmonary Embolism (less likely, no recent immobilization or risk factors) 5. Pericarditis (less likely, no positional pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Immediate ECG acquisition and interpretation - Oxygen administration and IV access - Pain management protocols initiation - Preparation for transport to nearest hospital with cardiac catheterization capabilities