Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. A five-story mixed-use building with commercial spaces on the ground floor and residential units above. Constructed in 1995, concrete structure with a single elevator and central stairwell. Main entrance is on Hafnarstræti, with a secondary entrance from the rear parking lot. Building has a basic intercom system. Current conditions: 7°C, clear skies, good visibility. GPS coordinates: 65.6823° N, 18.0921° W. Nearest landmark: Akureyri Art Museum.
63-year-old male, experiencing sudden onset chest pain. Primary symptoms: Severe, crushing chest pain radiating to the left arm and jaw, shortness of breath, diaphoresis. Secondary symptoms: Nausea, dizziness. Patient is conscious but anxious. Patient is sitting on the sofa in his living room. Medical history: Hypertension, hyperlipidemia, type 2 diabetes. Medications: Metformin 500mg twice daily, Atorvastatin 20mg daily, Lisinopril 10mg daily, Aspirin 75mg daily. Known allergy to penicillin. Last meal was a sandwich at 12:00.
Timeline: 1330 hours: Patient began experiencing mild chest discomfort while watching television. 1335 hours: Chest pain became severe and radiating to the left arm and jaw. 1338 hours: Patient developed shortness of breath and diaphoresis. 1340 hours: Patient called his son for help. 1342 hours: Son arrived and called emergency services. 1345 hours: Current time, patient still on sofa, experiencing severe chest pain. Prior Events: Patient reports occasional mild chest discomfort with exertion in the past. Last medical check-up 6 months ago, routine follow-up. No recent illnesses or injuries. Patient has a history of smoking, quit 5 years ago. No family history of early heart disease.
Initial Impression: Suspected Acute Coronary Syndrome (ACS) - Possible Myocardial Infarction Justification for F2 Classification: - High probability of a life-threatening cardiac event based on symptoms - Severe chest pain, radiating pain, shortness of breath, diaphoresis - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Myocardial Infarction (high probability) 2. Unstable Angina (high probability) 3. Aortic Dissection (less likely, no reported tearing pain) 4. Pulmonary Embolism (less likely, no reported pleuritic pain) 5. Musculoskeletal Chest Pain (less likely given severity and associated symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG monitoring and interpretation - Oxygen administration - Aspirin administration (if not already taken) - Preparation for transport to nearest hospital with cardiac catheterization lab