Hafnarstræti 22, 600 Akureyri, third floor apartment 3B. A five-story concrete building built in 1985. Main entrance has a coded lock, code is 1985. There is one elevator and a central stairwell. Street parking is available, but can be limited during peak hours. Building is equipped with a fire alarm system. Current conditions: 7°C, cloudy, good visibility. GPS coordinates: 65.6831° N, 18.0931° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing sudden onset of severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm, shortness of breath, diaphoresis. Secondary symptoms: Nausea, dizziness. Patient is conscious but anxious. Skin is pale and clammy. Patient is sitting on a chair in his living room. Medical history: Hypertension, hyperlipidemia, type 2 diabetes. Medications: Metformin 1000mg twice daily, Atorvastatin 20mg daily, Lisinopril 20mg daily. Known allergy: Sulfa drugs. Last meal was a sandwich at 13:00.
Timeline: 1400 hours: Patient was watching TV when he experienced sudden chest pain 1402 hours: Pain intensified, radiating to left arm, shortness of breath 1403 hours: Patient became diaphoretic and nauseous 1405 hours: Patient called his son for help 1407 hours: Son arrived, called emergency services 1409 hours: Current time, patient still sitting on chair, in severe pain Prior Events: Patient has a history of stable angina, no recent hospitalizations. Last medical check-up 6 months ago, routine follow-up. Patient is a former smoker, quit 10 years ago. No recent illnesses or injuries. Son reports patient has been stressed lately due to work issues.
Initial Impression: Suspected Acute Coronary Syndrome (ACS) - possible Myocardial Infarction Justification for F2 Classification: - Presentation consistent with ACS: severe chest pain, radiation, diaphoresis, shortness of breath - Risk factors: hypertension, hyperlipidemia, diabetes, previous angina - Time-sensitive condition requiring rapid intervention to prevent further myocardial damage Differential Diagnoses: 1. Myocardial Infarction (high probability) 2. Unstable Angina (likely) 3. Aortic Dissection (less likely, no back pain) 4. Pulmonary Embolism (less likely, no hemoptysis) 5. Esophageal Spasm (less likely, pain is not related to food intake) Required Actions: - Dispatch of ground EMS with ALS capabilities - Immediate ECG acquisition and interpretation - Administration of oxygen and aspirin if not contraindicated - Preparation for transport to nearest hospital with cardiac catheterization capabilities - Early hospital notification to activate cardiac team