Hafnarstræti 18, 600 Akureyri, ground floor of a two-story wooden building, built in 1950. Main entrance is street-level with a small step. No elevator. Street parking available. Building has basic fire safety equipment. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6827° N, 18.0889° W. Nearest landmark: Hof Cultural and Conference Center.
65-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain, radiating to the left arm, shortness of breath, diaphoresis. Secondary symptoms: Nausea, dizziness. Patient is conscious but anxious. Skin pale and clammy. Patient 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, Aspirin 75mg daily. Allergies: Penicillin. Last meal: Light lunch at 12:00.
Timeline: 1410 hours: Patient experienced sudden onset of chest pain while working at his desk. 1412 hours: Pain intensified, radiating to left arm. Patient became diaphoretic and short of breath. 1415 hours: Patient called his son for assistance. 1418 hours: Son arrived, called emergency services. 1420 hours: Current time, patient still experiencing chest pain, sitting in a chair. Prior Events: Patient has had occasional mild chest discomfort in the past, attributed to indigestion. No prior heart attacks. Last medical check-up 6 months ago, routine follow-up. Patient has a history of smoking but quit 5 years ago. Family history of heart disease.
Initial Impression: Suspected Acute Myocardial Infarction (AMI) Justification for F2 Classification: - High probability of cardiac event based on classic symptoms (crushing chest pain, radiation, diaphoresis, shortness of breath) - Time-sensitive condition requiring prompt medical intervention to reduce myocardial damage - Patient has multiple risk factors for heart disease (hypertension, hyperlipidemia, diabetes, family history) Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Angina Pectoris (less likely given severity and radiation of pain) 3. Pulmonary Embolism (less likely given absence of pleuritic pain and hemoptysis) 4. Aortic Dissection (less likely given absence of tearing pain and pulse deficit) Required Actions: - Dispatch of ground EMS with ALS capabilities - Immediate ECG acquisition - Oxygen administration - Pain management with nitroglycerin and morphine (if appropriate) - Preparation for transport to nearest hospital with cardiac catheterization lab