Hafnarstræti 21, 600 Akureyri, third floor apartment 3B. A five-story concrete building constructed in 1990. Main entrance uses a key code, intercom access for each apartment. There is one elevator and a central stairwell. Limited street parking available. The building has a fire alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6822° N, 18.0918° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm, shortness of breath, diaphoresis. Patient is pale and anxious. Secondary symptoms: Nausea, dizziness. Patient is conscious and alert but appears unwell. Patient is sitting in a chair in his living room. Medical history: Hypertension, hyperlipidemia, Type 2 diabetes. Medications: Metformin 500mg BID, Atorvastatin 20mg daily, Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a light lunch at 12:30.
Timeline: 1345 hours: Patient began experiencing mild chest discomfort. 1355 hours: Chest pain intensified, radiating to left arm, patient became diaphoretic. 1400 hours: Patient experienced shortness of breath, nausea, and dizziness. 1405 hours: Patient called his son for help. 1410 hours: Son arrived and called emergency services. 1412 hours: Current time, patient is still experiencing chest pain. Prior Events: Patient has a history of stable angina, but reports that this pain is significantly different. Last medical check-up was 6 months ago, routine follow-up. No recent illnesses or injuries. Patient is a smoker (20 pack-years).
Initial Impression: Suspected Acute Coronary Syndrome (ACS), likely Myocardial Infarction Justification for F2 Classification: - High probability of acute cardiac event based on symptoms (severe chest pain, radiation, diaphoresis, shortness of breath) - Potential for rapid deterioration and life-threatening complications - Requires prompt medical evaluation, ECG, and potential intervention Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (likely, requires further evaluation) 3. Aortic Dissection (less likely, but possible given chest pain) 4. Pulmonary Embolism (less likely, but possible given shortness of breath) 5. Musculoskeletal chest pain (less likely, given severity and associated symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG monitoring and acquisition - Administration of oxygen - Aspirin administration if no contraindications - IV access establishment - Preparation for transport to nearest hospital with cardiac catheterization lab