Hafnarstræti 18, 600 Akureyri. Ground floor of a two-story commercial building, constructed in 1965, concrete structure with large glass storefront. Main entrance on the street level, no stairs. Rear access through a loading dock. No known security features. Current weather: 8°C, overcast, light wind. GPS coordinates: 65.6822° N, 18.0914° W. Nearest landmark: Akureyri Art Museum.
55-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain, radiating to left arm and jaw, shortness of breath, diaphoresis. Patient is conscious but distressed. Secondary symptoms: Nausea, dizziness. Patient is sitting in a chair in his office. Medical history: Hypertension, hyperlipidemia, type 2 diabetes. Medications: Metformin 1000mg twice daily, Atorvastatin 40mg daily, Lisinopril 20mg daily. Known allergy: Sulfa drugs. Last meal was lunch at 13:00.
Timeline: 1430 hours: Patient started feeling mild chest discomfort. 1445 hours: Chest pain intensified, radiating to left arm and jaw, shortness of breath began. 1450 hours: Patient became diaphoretic and nauseous, called his colleague for help. 1452 hours: Colleague called emergency services. 1455 hours: Current time, patient sitting in chair, pale and diaphoretic. Prior Events: Patient reports similar, but milder, episodes of chest pain in the past few weeks. Attributed to indigestion. Last medical check-up 6 months ago, routine follow-up. Family history of heart disease (father had a heart attack at age 60). Patient is a smoker (1 pack per day for 30 years).
Initial Impression: Suspected Acute Coronary Syndrome (ACS) / Myocardial Infarction (MI) Justification for F2 Classification: - High probability of a life-threatening cardiac event based on symptoms. - Severe chest pain, radiation, shortness of breath, and diaphoresis are classic ACS signs. - Patient has multiple risk factors for heart disease (smoking, hypertension, diabetes, hyperlipidemia, family history). - Time-sensitive condition requiring prompt medical evaluation and treatment. Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (likely, but less severe) 3. Aortic Dissection (less likely, no ripping or tearing pain) 4. Pulmonary Embolism (less likely, no hemoptysis) 5. Esophageal Spasm (less likely, pain is more severe and radiating) Required Actions: - Dispatch of ground EMS with ALS capabilities - Immediate ECG acquisition and interpretation - Oxygen administration and IV access - Preparation for rapid transport to nearest hospital with cardiac catheterization capabilities - Pre-arrival notification of the hospital emergency department