Hafnarstræti 18, 600 Akureyri. Third floor, apartment 3B. Four-story concrete building, built in 1965, with a single entrance at street level. Elevator and central staircase. Street parking available, can be limited. Fire alarm system installed. Current conditions: 8°C, clear skies, good visibility. GPS coordinates: 65.6823° N, 18.0911° W. Nearest landmark: Akureyri Art Museum.
68-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 lightheaded and anxious. Secondary symptoms: Nausea, feeling of impending doom. Patient is conscious and alert, but pale and distressed. Patient is sitting on a chair in his living room. Medical history: Type 2 diabetes, hypertension, hypercholesterolemia, previous CABG 5 years ago. Medications: Metformin 1000mg twice daily, Lisinopril 20mg daily, Atorvastatin 40mg daily, Aspirin 75mg daily. Allergies: None known. Last meal was a light lunch at 13:00.
Timeline: 1415 hours: Patient started experiencing mild chest discomfort while watching TV 1420 hours: Chest pain intensified, radiating to left arm and jaw 1422 hours: Patient developed shortness of breath and diaphoresis 1425 hours: Patient called his son for help, who arrived within minutes 1428 hours: Son called emergency services 1430 hours: Current time, patient is still experiencing severe chest pain, sitting upright Prior Events: Patient reports no recent changes in his medical condition. Last check-up was 2 months ago, routine follow-up. Patient has been compliant with medications. No recent illnesses or injuries. No prior incidents of chest pain of this severity.
Initial Impression: Suspected Acute Coronary Syndrome (ACS), likely Myocardial Infarction Justification for F2 Classification: - High probability of cardiac event based on symptoms and medical history - Severe chest pain, radiation, shortness of breath, diaphoresis - Previous CABG increases risk for ACS - Time-sensitive condition requiring rapid intervention Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (likely, but less severe than MI) 3. Aortic Dissection (less likely, no reported tearing pain) 4. Pulmonary Embolism (less likely, no reported sudden onset of dyspnea) Required Actions: - Dispatch of ground EMS with ALS capabilities - Immediate ECG acquisition - Oxygen administration if SpO2 is low - Aspirin administration if not already taken - Preparation for transport to nearest hospital with cardiac catheterization lab