Hafnarstræti 19, 600 Akureyri, ground floor, commercial space converted to a small apartment. One-story wooden structure, built in 1925, with a single entrance facing the street. No elevator. Street parking available. Building equipped with smoke detectors. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6828° N, 18.0903° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain, radiating to left arm and jaw, shortness of breath, diaphoresis. Patient reports feeling 'very unwell'. Secondary symptoms: Nausea, dizziness. Patient is conscious but anxious. Skin pale and clammy. Patient is sitting on a chair in his living room. Medical history: Hypertension, hyperlipidemia, type 2 diabetes, family history of heart disease. Medications: Metformin 500mg twice daily, Atorvastatin 20mg daily, Lisinopril 10mg daily. Allergies: None known. Last meal was a sandwich at 12:00.
Timeline: 1315 hours: Patient began experiencing mild chest discomfort 1320 hours: Chest pain intensified, radiating to left arm and jaw 1322 hours: Patient began experiencing shortness of breath and sweating 1325 hours: Patient called his son for help 1328 hours: Son arrived, called emergency services 1330 hours: Current time, patient sitting on a chair, in severe pain Prior Events: Patient reports occasional mild chest discomfort in the past few months, attributed to indigestion. No recent illnesses or injuries. Last medical check-up 6 months ago, routine follow-up. Patient lives alone, but son lives nearby.
Initial Impression: Suspected Acute Coronary Syndrome (ACS), likely Myocardial Infarction Justification for F2 Classification: - High probability of a life-threatening cardiac event based on symptoms - Severe chest pain, radiation, shortness of breath, diaphoresis - Time-sensitive condition requiring rapid intervention Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (high probability) 3. Aortic Dissection (less likely, no tearing pain) 4. Pulmonary Embolism (less likely, no sudden onset of dyspnea without chest pain) 5. Gastroesophageal Reflux (less likely given severity and radiation of pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Initiate cardiac monitoring and oxygen administration - Obtain 12-lead ECG and transmit to hospital - Preparation for transport to nearest hospital with cardiac catheterization lab