Hafnarstræti 18, 600 Akureyri. Second floor of a three-story commercial building, built in 1960, with a mix of retail and office spaces. Main entrance from Hafnarstræti street, accessible by stairs. No elevator. Emergency exit on the back side leading to a parking lot. Building has standard fire alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6823° N, 18.0912° W. Nearest landmark: Akureyri Art Museum.
55-year-old male, experiencing sudden onset of severe chest pain. Primary symptoms: Crushing chest pain radiating to the left arm, shortness of breath, diaphoresis. Secondary symptoms: Nausea, dizziness. Patient is conscious but anxious. Skin is pale and clammy. Patient is at his office desk. Medical history: Type 2 diabetes, hypercholesterolemia, previous smoker (quit 5 years ago). Medications: Metformin 1000mg twice daily, Atorvastatin 20mg daily. No known allergies. Last meal was a light lunch at 12:00.
Timeline: 13:45 hours: Patient began experiencing mild chest discomfort while working at his desk. 13:50 hours: Chest pain became severe, radiating to left arm, accompanied by shortness of breath. 13:52 hours: Patient started feeling nauseous and dizzy, broke out in a sweat. 13:55 hours: Patient called emergency services. 13:56 hours: Current time, patient is sitting at his desk, experiencing severe chest pain, waiting for help. Prior Events: Patient had a routine check-up 6 months ago with normal ECG. No recent illnesses. Patient reports occasional mild chest discomfort during exercise, which he attributed to being out of shape. No recent travel or unusual activity.
Initial Impression: Acute Coronary Syndrome (ACS), likely Myocardial Infarction Justification for F2 Classification: - High probability of a life-threatening cardiac event based on symptom presentation (severe chest pain, radiation, diaphoresis, shortness of breath) - Time-sensitive condition requiring rapid intervention to minimize myocardial damage - Patient has risk factors (diabetes, hypercholesterolemia, smoking history) Differential Diagnoses: 1. Myocardial Infarction (high probability) 2. Unstable Angina (less likely, pain is severe and persistent) 3. Aortic Dissection (less likely, no reported tearing pain) 4. Pulmonary Embolism (less likely, no recent travel or surgery) 5. Esophageal Spasm (less likely, pain is severe and radiating) Required Actions: - Dispatch of ground EMS with ALS capabilities - Rapid transport to the nearest hospital with cardiac catheterization lab - ECG monitoring and acquisition - Oxygen administration and intravenous access