Hafnarstræti 23, 600 Akureyri. Ground floor of a two-story commercial building, built in 1965, concrete structure. Main entrance facing Hafnarstræti, no security features. One main entrance, several large windows on the street side. No elevator. Parking on street, limited. Current weather: 7°C, overcast, good visibility. GPS coordinates: 65.6821° N, 18.0915° W. Nearest landmark: Akureyri Art Museum.
58-year-old male, experiencing severe chest pain. Primary symptoms: Sudden onset of crushing chest pain, radiating to left arm and jaw, shortness of breath, diaphoresis. Patient reports feeling lightheaded and nauseous. Secondary symptoms: Anxiety, pale skin. Patient is conscious but distressed, sitting on a chair in his office. Medical history: Hypertension, hypercholesterolemia, family history of heart disease. Medications: Lisinopril 10mg daily, Atorvastatin 20mg daily. No known allergies. Last meal was a light lunch at 12:30.
Timeline: 1345 hours: Patient began experiencing mild chest discomfort. 1350 hours: Chest pain increased in severity, radiating to left arm and jaw. 1352 hours: Patient became short of breath and diaphoretic. 1355 hours: Patient called his coworker for assistance. 1357 hours: Coworker called emergency services. 1358 hours: Current time, patient still sitting, experiencing severe chest pain. Prior Events: Patient reports occasional mild chest discomfort in the past, attributed to indigestion. No prior cardiac events. Last medical check-up 6 months ago, routine follow-up. Patient works as an accountant.
Initial Impression: Suspected Acute Myocardial Infarction (AMI) Justification for F2 Classification: - Classic symptoms of AMI: crushing chest pain, radiation, diaphoresis, dyspnea - High risk factors: hypertension, hypercholesterolemia, family history of heart disease - Time-sensitive condition requiring immediate medical intervention Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Angina Pectoris (less likely given severity and duration) 3. Aortic Dissection (less likely, no tearing pain reported) 4. Pulmonary Embolism (less likely, no recent surgery or immobilization) Required Actions: - Dispatch of ground EMS with ALS capabilities - Immediate ECG acquisition and interpretation - Oxygen administration - Aspirin administration if not contraindicated - Preparation for transport to nearest hospital with cardiac catheterization capabilities