Hafnarstræti 92, 600 Akureyri, third floor apartment 3B. Five-story concrete building, constructed in 1995. Main entrance has a coded lock (code 1234). Elevator and central stairwell available. Street parking. Building has a basic fire alarm system. Current conditions: 8°C, cloudy, good visibility. GPS coordinates: 65.6832° N, 18.0889° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing chest pain. Primary symptoms: severe, crushing chest pain, radiating to left arm, shortness of breath, diaphoresis. Secondary symptoms: nausea, dizziness. Patient alert and anxious. Skin pale and clammy. Patient sitting on a chair in his living room. Medical history: hypertension, hyperlipidemia, type 2 diabetes, previous angina. Medications: Metformin 1000mg twice daily, Atorvastatin 20mg daily, Lisinopril 10mg daily, Aspirin 75mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 14:00 hours: Patient started experiencing mild chest discomfort while watching TV. 14:15 hours: Chest pain increased in severity, radiating to left arm, shortness of breath started. 14:20 hours: Patient became diaphoretic and nauseous, called his son for help. 14:25 hours: Son arrived and called emergency services. 14:27 hours: Current time, patient sitting in a chair, experiencing severe chest pain. Prior Events: Patient has a history of angina, experiencing similar but less severe episodes in the past. Last medical check-up 6 months ago, routine follow-up. No recent hospitalizations. Patient reports no recent unusual physical activity or stressors.
Initial Impression: Suspected Acute Coronary Syndrome - Non-STEMI Justification for F2 Classification: - High probability of cardiac event based on presenting symptoms (chest pain, radiation, diaphoresis, shortness of breath) - Patient has multiple risk factors (hypertension, hyperlipidemia, diabetes, previous angina) - Condition is time-sensitive and requires urgent medical evaluation and intervention Differential Diagnoses: 1. Non-ST-segment elevation myocardial infarction (NSTEMI) (high probability) 2. Unstable Angina (high probability) 3. Aortic Dissection (less likely given the gradual onset and lack of tearing pain) 4. Pulmonary Embolism (less likely given the lack of pleuritic pain and sudden onset) 5. Musculoskeletal chest pain (less likely given the severity, radiation, and associated symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG monitoring and interpretation - Oxygen administration if needed - Pain management protocols initiation (e.g., nitrates, morphine) - Preparation for transport to nearest hospital with cardiac services