Hafnarstræti 19, 600 Akureyri. Ground floor of a two-story commercial building, built in 1965, with a small storefront and a back office area. Main entrance is directly from the street. No elevator. Street parking available. Building has a basic security system with a key code. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6812° N, 18.0911° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm, shortness of breath, diaphoresis. Patient reports feeling lightheaded and anxious. Secondary symptoms: Nausea. Patient is alert but distressed. Skin is pale and clammy. Patient is sitting on a chair in his office. Medical history: Hypertension, hyperlipidemia, Type 2 diabetes. Medications: Metformin 1000mg twice daily, Atorvastatin 20mg daily, Lisinopril 10mg daily. No known allergies. Last meal was a sandwich at 12:30.
Timeline: 1345 hours: Patient started experiencing chest discomfort while working at his desk 1350 hours: Pain increased in intensity, radiating to left arm, patient became short of breath 1352 hours: Patient started sweating profusely, felt nauseous and lightheaded 1355 hours: Patient called his son for help, who then called emergency services 1358 hours: Current time, patient still in office, experiencing severe chest pain Prior Events: Patient has a history of stable angina, but this episode is significantly worse. Last cardiac check-up 6 months ago, routine follow-up. No recent illnesses or injuries. Patient reports increased stress at work recently.
Initial Impression: Suspected Acute Coronary Syndrome (ACS) - Possible Myocardial Infarction Justification for F2 Classification: - High probability of a cardiac event based on chest pain, radiation, diaphoresis, and shortness of breath - Patient has multiple risk factors for ACS (age, hypertension, diabetes, hyperlipidemia) - Time-sensitive condition requiring rapid assessment and treatment Differential Diagnoses: 1. Acute 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 severity and radiation) Required Actions: - Dispatch of ground EMS with ALS capabilities - Initiate cardiac monitoring and oxygen administration - Prepare for potential administration of aspirin and nitroglycerin - Early hospital notification with cardiac catheterization lab availability