Hafnarstræti 18, 600 Akureyri, ground floor of a two-story wooden building, built in 1920. Main entrance faces the street, no steps. Rear access from parking lot, one small step. No security features. Weather: Clear, 8°C, good visibility. GPS: 65.6823° N, 18.0914° W. Landmark: Near the Akureyri Art Museum.
65-year-old male, experiencing severe chest pain. Primary symptom: crushing chest pain radiating to left arm and jaw, onset 15 minutes ago. Secondary symptoms: shortness of breath, nausea, diaphoresis. Patient alert and anxious. Patient is sitting in a chair in his office. Medical history: Hypertension, hyperlipidemia. Medications: Ramipril 10mg daily, Atorvastatin 20mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1415 hours: Patient reports sudden onset of severe chest pain while at his desk. 1416 hours: Patient experiences radiating pain to left arm and jaw, starts sweating profusely. 1417 hours: Patient calls his son, who is in the next office, for help. 1418 hours: Son arrives, notes patient's distress, calls emergency services. 1420 hours: Current time, patient still seated, pale, and distressed. Prior Events: Patient reports occasional mild chest discomfort in the past month, attributed to indigestion. No prior cardiac events. Last medical check-up was 6 months ago, routine follow-up. Patient is a non-smoker, occasional alcohol use.
Initial Impression: Suspected Acute Myocardial Infarction (AMI) Justification for F2 Classification: - High probability of a serious cardiac event based on classical presentation (chest pain, radiation, diaphoresis) - Time-sensitive condition requiring rapid intervention to minimize myocardial damage - Patient is symptomatic, anxious, and requires immediate medical assessment Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Angina Pectoris (less likely given severity and onset) 3. Aortic Dissection (less likely given lack of tearing pain) 4. Pulmonary Embolism (less likely given lack of specific risk factors) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG acquisition and interpretation - Oxygen administration - Aspirin administration (if no contraindications) - Preparation for transport to nearest hospital with cardiac catheterization lab