Hafnarstræti 23, 600 Akureyri, third floor apartment 3B. A five-story concrete building built in 1995. Main entrance has a key code and intercom. There is an elevator and a central staircase. Street parking is available. Building has a fire alarm system. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 65.6822° N, 18.0894° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing chest pain. Primary symptoms: Central chest pain described as pressure, radiating to the left arm, and associated with shortness of breath. Secondary symptoms: Mild diaphoresis, nausea. Patient is alert and anxious. Medical history: Hypertension, hypercholesterolemia, type 2 diabetes. Medications: Metformin 1000mg twice daily, Atorvastatin 20mg daily, Lisinopril 10mg daily. No known allergies. Last meal was lunch at 13:00.
Timeline: 1400 hours: Patient started experiencing chest discomfort while resting. 1410 hours: Chest pain intensified, radiating to left arm, associated with shortness of breath. 1415 hours: Patient felt nauseous and started sweating. He took a nitroglycerin tablet, but the pain persisted. 1420 hours: Patient called his son, Jón Einarsson, who then called emergency services. 1422 hours: Current time, patient is sitting on a chair, still experiencing chest pain. Prior Events: Patient has a history of stable angina, but this episode is more severe and prolonged than usual. Last medical check-up 6 months ago, routine follow-up for chronic conditions. No recent illnesses or injuries. Patient lives alone, but his son lives nearby.
Initial Impression: Suspected Acute Coronary Syndrome (Non-STEMI) Justification for F2 Classification: - High probability of acute cardiac event based on chest pain characteristics, radiation, and associated symptoms - Patient has multiple risk factors for coronary artery disease (hypertension, hypercholesterolemia, diabetes) - Time-sensitive condition requiring prompt medical evaluation and intervention - Non-STEMI is suspected due to the absence of ST-segment elevation on ECG, if available, but requires immediate assessment. Differential Diagnoses: 1. Acute Coronary Syndrome (Non-STEMI) (high probability) 2. Unstable Angina (high probability) 3. Aortic Dissection (less likely given presentation) 4. Pericarditis (less likely given radiation of 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 if needed - Aspirin administration if not contraindicated - Preparation for transport to nearest hospital with cardiac catheterization capabilities