Hafnarstræti 7, 600 Akureyri, ground floor of a two-story wooden building built in 1935, now a small office. Main entrance faces the street, with a small step. No elevator. Street parking available. Building has a basic security system (door lock). Current conditions: 7°C, cloudy, good visibility. GPS coordinates: 65.6823° N, 18.0925° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe chest pain. Primary symptoms: Sudden onset of crushing chest pain, radiating to left arm and jaw. Secondary symptoms: Shortness of breath, diaphoresis, nausea. Patient is conscious and alert but anxious. Skin pale and clammy. Patient sitting in his office chair. Medical history: Type 2 diabetes, hypertension, hypercholesterolemia. Medications: Metformin 1000mg twice daily, Lisinopril 20mg daily, Atorvastatin 40mg daily. No known allergies. Last meal was a light lunch at 12:00.
Timeline: 1345 hours: Patient reports feeling mild chest discomfort. 1350 hours: Chest pain intensifies rapidly, becomes severe. 1352 hours: Pain radiates to left arm and jaw, patient becomes short of breath. 1353 hours: Patient calls emergency services. 1355 hours: Current time, patient still experiencing severe chest pain. Prior Events: Patient reports occasional mild chest discomfort over the past few weeks, attributed to indigestion. No prior cardiac events. Last medical check-up 6 months ago, routine follow-up. Patient has a family history of heart disease. Smoker (1 pack per day).
Initial Impression: Suspected Acute Coronary Syndrome (ACS), likely Myocardial Infarction (MI) Justification for F2 Classification: - High probability of a cardiac event based on presentation - Severe chest pain, radiating to left arm and jaw, shortness of breath - Time-sensitive condition requiring prompt medical evaluation and intervention Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (less likely given severity of pain) 3. Aortic Dissection (less likely, no tearing pain) 4. Pulmonary Embolism (less likely, no sudden onset of breathlessness prior to chest pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG monitoring and interpretation - Oxygen administration and IV access - Aspirin administration and pain management - Early hospital notification for potential cardiac catheterization