Hafnarstræti 20, 600 Akureyri, ground floor of a two-story wooden building constructed in 1950, now a commercial space. Main entrance is street-level with a single door. No elevator. Limited parking on the street. Building has a basic fire alarm system. Current conditions: 7°C, overcast, light wind. GPS coordinates: 65.6824° N, 18.0912° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm and jaw, shortness of breath, diaphoresis. Patient reports sudden onset of symptoms while at work. Secondary symptoms: Nausea, dizziness. Patient is conscious but distressed. Skin pale and clammy. Patient is sitting on a chair in his office. Medical history: Hypertension, hypercholesterolemia, smoker (20 pack-years). Medications: Lisinopril 20mg daily, Atorvastatin 40mg daily, Aspirin 75mg daily. No known allergies. Last meal was a sandwich at 12:00.
Timeline: 1345 hours: Patient started feeling mild chest discomfort. 1350 hours: Chest pain intensified, radiating to left arm and jaw. Patient became short of breath and diaphoretic. 1352 hours: Patient called his colleague for help. 1355 hours: Colleague called emergency services. 1357 hours: Current time, patient still in office, experiencing severe chest pain. Prior Events: Patient reports occasional mild chest discomfort in the past month, but no prior episodes of this severity. Last medical check-up 6 months ago, routine follow-up. Patient has a family history of heart disease. Patient was working on his computer when symptoms began.
Initial Impression: Suspected Acute Myocardial Infarction (AMI) Justification for F2 Classification: - High probability of life-threatening condition based on classic symptoms of AMI. - Severe chest pain, radiation, diaphoresis, shortness of breath. - Time-sensitive condition requiring rapid medical intervention to prevent further cardiac damage. Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Angina Pectoris (less likely given severity and duration of pain) 3. Aortic Dissection (lower probability, no reported back pain) 4. Pulmonary Embolism (lower probability, no reported sudden onset of dyspnea without chest pain) Required Actions: - Dispatch of ground EMS with ALS capabilities. - Immediate initiation of cardiac protocols, including ECG. - Oxygen administration and IV access. - Preparation for transport to nearest hospital with cardiac catheterization lab.