Hafnarstræti 23, 600 Akureyri. Ground floor of a two-story wooden commercial building constructed in 1950. Main entrance faces the street, no security features. No elevator. Street parking available. Building equipped with basic fire extinguishers. Current conditions: 7°C, overcast, light wind, good visibility. GPS coordinates: 65.6834° N, 18.0899° W. Nearest landmark: Akureyri Art Museum.
66-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm, shortness of breath, diaphoresis. Patient reports feeling dizzy and nauseous. Patient is alert but anxious. Skin is pale and clammy. Patient is 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. No known allergies. Last meal was a light lunch at 12:00.
Timeline: 1330 hours: Patient reports sudden onset of severe chest pain while at work 1332 hours: Patient became diaphoretic and short of breath 1334 hours: Patient called his colleague for help 1335 hours: Colleague called emergency services 1337 hours: Current time, patient is sitting, still in severe pain Prior Events: Patient reports occasional mild chest discomfort in the past few months, attributed to indigestion. No prior history of heart attack or angina. Last medical check-up 6 months ago, routine follow-up. Patient is a smoker (20 cigarettes per day). Family history of heart disease (father had a heart attack at 70).
Initial Impression: Suspected Acute Coronary Syndrome (ACS) Justification for F2 Classification: - High probability of cardiac event based on presenting symptoms - Severe chest pain, radiation to arm, diaphoresis, shortness of breath - Time-sensitive condition requiring immediate medical 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 recent travel or surgery) 5. Gastroesophageal Reflux (less likely given severity and associated symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - Cardiac monitoring and ECG acquisition - Oxygen administration - Pain management protocols initiation - Rapid transport to nearest hospital with cardiac catheterization lab