Hafnarstræti 18, 600 Akureyri, ground floor of a two-story commercial building, former retail space now used as a small office. Main entrance is street-level with a single glass door. No elevator. Building is approximately 40 years old, concrete construction. Street parking available. Current conditions: 7°C, overcast, light wind. GPS coordinates: 65.6823° N, 18.0917° W. Nearest landmark: Akureyri Art Museum.
56-year-old male, complaining of severe chest pain. Primary symptoms: Crushing chest pain, radiating to left arm, shortness of breath, diaphoresis. Patient reports onset of symptoms 20 minutes ago while at work. Secondary symptoms: Nausea, dizziness. Patient is pale and anxious. Medical history: Hypertension, hyperlipidemia, family history of heart disease. Medications: Atorvastatin 20mg daily, Lisinopril 10mg daily. No known allergies. Last meal was a sandwich at 12:00.
Timeline: 1315 hours: Patient reports onset of chest pain while working at his desk. 1318 hours: Patient reports increasing chest pain, radiating to left arm, shortness of breath, diaphoresis. 1320 hours: Patient calls emergency services. 1322 hours: Current time, patient still experiencing severe chest pain and associated symptoms. Prior Events: Patient reports occasional mild chest discomfort in the past few months, attributed to stress. No prior cardiac events. Last medical check-up 6 months ago, routine follow-up. Patient is a smoker, approximately 1 pack per day for 30 years.
Initial Impression: Suspected Acute Coronary Syndrome (ACS), likely Myocardial Infarction (MI) Justification for F2 Classification: - High probability of acute cardiac event based on classic symptoms (chest pain, radiation, diaphoresis, shortness of breath) - Time-sensitive condition requiring rapid assessment and intervention - Potential for rapid deterioration to life-threatening arrhythmia Differential Diagnoses: 1. Myocardial Infarction (high probability) 2. Unstable Angina (high probability) 3. Aortic Dissection (less likely, no tearing pain reported) 4. Pulmonary Embolism (less likely, no risk factors reported) 5. Musculoskeletal Chest Pain (less likely, given the severity and radiation) Required Actions: - Dispatch of ground EMS with ALS capabilities - Immediate ECG acquisition and interpretation - Oxygen administration - Pain management protocols initiation - Preparation for transport to nearest hospital with cardiac catheterization lab